Retrospective observatory comparison of lumbar interbody fusion with pedicle screw fixation and cortical screw fixation for clinical outcome, including sagittal balance, in geriatric patients over 80 years old: a single-center, one-decade experience

Abstract

Background We aimed to retrospectively analyze the clinical and surgical outcomes following posterior lumbar interbody fusion plus pedicle screw fixation compared to midline lumbar fusion in patients aged ≥ 80 years with degenerative lumbar spine disease. Methods The study group comprised 68 patients aged ≥ 80 who underwent degenerative lumbar spinal surgery at our spine center between January 2011 and December 2020. Among them, 24 underwent posterior lumbar interbody fusion plus pedicle screw fixation, and the remaining 44 underwent midline lumbar fusion. Results No significant intergroup differences were found in age, sex ratio, follow-up duration, or surgical level. The Visual Analog Scale for lower back pain was significantly different between the two groups at 7 days after surgery (P = 0.049). The Oswestry Disability Index was significantly different between the two groups at 7 days after surgery (P = 0.05). The estimated blood loss and operative time differed significantly (P < 0.05). There was a statistically significant difference in the postoperative morbidities between the groups (P = 0.049). Conclusions Although the clinical outcomes were not significantly different between the two groups, the perioperative morbidity was better in the midline lumbar fusion group. Therefore, we conclude that midline lumbar fusion is not inferior to posterior lumbar interbody fusion plus pedicle screw fixation if there is a need for fusion in elderly patients over octogenarian. Trial registration The Institutional Review Board of National Health Insurance Service Ilsan Hospital approved this study (2022-01-027), and the requirement of informed consent was waived due to the study's retrospective nature.

The effect of the cortical bone trajectory screw fixation and traditional pedicle screw fixation on surgical site wound infection in posterior lumbar fusion wound: A meta‐analysis

“…In investigations that were considered for the meta-analysis, 1195 individuals with PLF were in the chosen investigations' starting point, 578 of them were using CBTSF, and 617 were using TPSF. [12][13][14][15][16][17][18][19][20][21][22][23][24] No significant difference was found between individuals using CBTSF and TPSF in SSWI, superficial SSWI, and deep SSWI in PLF. Though precautions must be exercised when dealing with its values since some of the selected investigations for this meta-analysis were with a low sample size (8 out of 13 were ≤100 individuals) and a low number of selected investigations for some parameters studied.…”

“…13 publications, published between 2015 and 2023, from a total of 1657 connected investigations that met the inclusion criteria were chosen and included in the investigation. [12][13][14][15][16][17][18][19][20][21][22][23][24] The results of these researches are presented in Table 2. 1195 individuals with PLF were in the chosen investigations' starting point, 578 of them were using CBTSF, and 617 were using TPSF.…”

“…13 publications, published between 2015 and 2023, from a total of 1657 connected investigations that met the inclusion criteria were chosen and included in the investigation 12‐24 . The results of these researches are presented in Table 2.…”

“…In investigations that were considered for the meta‐analysis, 1195 individuals with PLF were in the chosen investigations' starting point, 578 of them were using CBTSF, and 617 were using TPSF 12‐24 . No significant difference was found between individuals using CBTSF and TPSF in SSWI, superficial SSWI, and deep SSWI in PLF.…”