我们研究了在全软骨切除术中PLIF增强交联的临床作用。我们回顾性分析了在2017年1月至2022年3月期间接受单或两段PLIF单侧或双侧全软骨切除术的376例患者。根据是否使用了交联,将患者分为两组。放射学结果测量包括术后12个月计算机断层扫描的融合状态和植入物失败率。患者报告的结果指标包括腰背痛的数字评定量表,Oswestry残疾指数,和简短形式-12物理组件汇总分数,在术前和术后12个月进行评估。手术相关并发症包括手术部位感染,有症状的植入物失败,和硬膜外血肿.在校正混杂因素后,进行倾向评分匹配以比较两组,包括基线和手术程序特征。共有200例纳入倾向得分计算,进行了一对一的匹配,导致56对有和没有交联。融合状态(88.7%vs.85.5%),螺钉松动(14.3%vs.14.3%),网箱沉降(17.9%vs.16.1%),和笼子移位(5.4%与0%)显示有和没有交联的那些之间没有显着差异,分别。两组患者报告的结果或与手术相关的并发症发生率没有显着差异。不建议在PLIF进行全关节切除术期间进行交联增强,因为它不提供任何放射学或临床益处,并且与可避免的费用有关。
We investigated the clinical role of
crosslink augmentation during PLIF with total facetectomy. We retrospectively reviewed 376 patients who underwent one- or two-segment PLIF with unilateral or bilateral total facetectomy between January 2017 and March 2022. The patients were categorized into two groups based on whether a
crosslink was instrumented or not. Radiological outcome measurements included fusion status and implant failure rates on 12-month postoperative computed tomography. Patient-reported outcome measures included the Numerical Rating Scale for lower back pain, Oswestry Disability Index, and Short Form-12 Physical Component Summary scores, which were assessed preoperatively and at 12 months postoperatively. Surgery-related complications included surgical site infection, symptomatic implant failure, and epidural hematoma. Propensity score matching was performed to compare both groups after adjusting for confounding factors, including baseline and surgical procedural characteristics. A total of 200 cases were included in the propensity score calculation, and one-to-one matching was performed, resulting in 56 pairs with and without a
crosslink. The fusion status (88.7 % vs. 85.5 %), screw loosening (14.3 % vs. 14.3 %), cage subsidence (17.9 % vs. 16.1 %), and cage dislodgement (5.4 % vs. 0 %) showed no significant difference between those with and without a
crosslink, respectively. No significant differences were observed in the patient-reported outcomes or surgery-related complication rates between the groups.
Crosslink augmentation during PLIF with total facetectomy is not recommended because it does not provide any radiological or clinical benefit and is associated with avoidable expenses.