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Does the Number of Interbody Devices Affect the Fusion Outcome in Short-Segment Posterior Lumbar Fusion? – Lumbar Fusion

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The article examines the use of interbody devices (IBDs) in posterior lumbar fusion (PLF) surgery and their impact on fusion outcomes such as adjacent segment pathology (ASP) and pseudarthrosis. The study consisted of a retrospective analysis of 2,061 patients, with 247 patients meeting the inclusion criteria. The results showed that the use of an IBD at each level of the fusion construct significantly reduced the rate of pseudarthrosis. However, there was no significant correlation between the rates of ASP. The study suggests the use of an IBD per fusion level in short-segment PLF surgeries. Further studies with larger sample sizes and longer follow-up times are recommended to validate the results

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
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Published article

S: In patients undergoing one- to three-level PLF surgery, the use of an IBD at all levels of the fusion construct significantly reduces the rate of pseudarthrosis. There was no significant correlation between the rates of ASP. Studies with a larger sample size and a longer follow-up time are suggested to validate our results for pseudoarthrosis and ASP. Our results suggest the use of an IBD per fusion level in short-segment PLF surgeries.

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Cureus. 2023 Dec 7;15(12):e50113. doi: 10.7759/cureus.50113. eCollection 2023 Dec.ABSTRACTINTRODUCTION: Interbody devices (IBDs) have been shown to improve outcomes when used in posterior lumbar fusion (PLF) surgery; however,the exact extent of their clinical benefit remains a current topic of interest. Our primary objective in this study was to identify whether the use of an IBD at,

Cureus. 2023 Dec 7;15(12):e50113. doi: 10.7759/cureus.50113. eCollection 2023 Dec.

ABSTRACT

INTRODUCTION: Interbody devices (IBDs) have been shown to improve outcomes when used in posterior lumbar fusion (PLF) surgery; however,the exact extent of their clinical benefit remains a current topic of interest. Our primary objective in this study was to identify whether the use of an IBD at every level of fusion construct would affect fusion outcomes such as adjacent segment pathology (ASP) and pseudarthrosis after one- to three-level PLF surgery.

METHODS: This was a single-institution retrospective study. We studied the association of factors such as smoking status, BMI, gender, age, and number of IBDs on the development of ASP and pseudarthrosis. To study the effect of independent variables on ASP and pseudoarthrosis, univariate and multivariate regression analyses were used.

RESULTS: The study included 2,061 patients with a history of posterior lumbar fusion who were identified and reviewed. Among these, 363 patients met our inclusion criteria; 247 patients had a minimum follow-up of six months and were finally included in the study. The median follow-up was 30 months. Among the 247 patients, 105 (42.5%) and 24 (9.7%) experienced ASP and pseudarthrosis, respectively. Gender and use of IBD significantly affected the presence of pseudarthrosis (with a higher rate in males and those without any IBDs). Gender, age, BMI, and use of IBDs did not affect ASP. Moreover, using an IBD at each fused level reduced the pseudarthrosis rate significantly compared to when IBDs were not used at all levels (7.3% vs. 27.6%, p <0.001), while there was no significant difference in the rate of ASP (43.6% vs. 34.5%, p = 0.35).

S: In patients undergoing one- to three-level PLF surgery, the use of an IBD at all levels of the fusion construct significantly reduces the rate of pseudarthrosis. There was no significant correlation between the rates of ASP. Studies with a larger sample size and a longer follow-up time are suggested to validate our results for pseudoarthrosis and ASP. Our results suggest the use of an IBD per fusion level in short-segment PLF surgeries.

PMID:38186530 | PMC:PMC10771103 | DOI:10.7759/cureus.50113

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Does the Number of Interbody Devices Affect the Fusion Outcome in Short-Segment Posterior Lumbar Fusion?

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Cureus. 2023 Dec 7;15(12):e50113. doi: 10.7759/cureus.50113. eCollection 2023 Dec.ABSTRACTINTRODUCTION: Interbody devices (IBDs) have been shown to improve outcomes when used in posterior lumbar fusion (PLF) surgery; however,the exact extent of their clinical benefit remains a current topic of interest. Our primary objective in this study was to identify whether the use of an IBD at

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