UNASSIGNED: A total of 199 patients who underwent LLIF (n = 106) or TLIF (n = 93) surgery from June 2019 to September 2021 were reviewed. The endplate injury was assessed by postoperative sagittal CT scan. A binary logistic analysis model were used to identify independent risk factors related to LLIF endplate injury based on univariate analysis.
UNASSIGNED: There was an obvious difference in the occurrence of intraoperative endplate injury between LLIF (42/106, 39.6%) and TLIF group (26/93, 28%), although it did not reach the significant level. L1 CT value (OR = 0.985, 95% CI = 0.972-0.998), cage position (OR = 3.881, 95% CI = 1.398-10.771) and height variance (OR = 1.263, 95% CI = 1.013-1.575) were independent risk factors for endplate injury in LLIF procedure. According to the cage settlement patterns, there 5 types of A to E. The severity of the facet joint degeneration was positively related to the occurrence of endplate injury.
UNASSIGNED: The incidence of intraoperative endplate injury is higher in LLIF than in TLIF procedures. Low bone quantity, cage posterior position and larger height variance are risk factors to induce endplate injury in LLIF surgery. The facet joint degeneration may be related to severe endplate injuries and even fractures.
■对从2019年6月至2021年9月接受LLIF(n=106)或TLIF(n=93)手术的199例患者进行了回顾。通过术后矢状位CT扫描评估终板损伤。采用二元logistic分析模型,在单因素分析的基础上确定与LLIF终板损伤相关的独立危险因素。
■LLIF组(42/106,39.6%)和TLIF组(26/93,28%)术中终板损伤的发生率有明显差异,虽然没有达到显著水平。L1CT值(OR=0.985,95%CI=0.972-0.998),笼位(OR=3.881,95%CI=1.398-10.771)和身高方差(OR=1.263,95%CI=1.013-1.575)是LLIF手术终板损伤的独立危险因素。根据网箱沉降模式,关节突关节退变的严重程度与终板损伤的发生呈正相关。
■LLIF术中终板损伤的发生率高于TLIF。骨量低,笼后位置和较大的高度方差是LLIF手术中引起终板损伤的危险因素。小关节退变可能与严重的终板损伤甚至骨折有关。