Incidence and Risk Factors of Lumbosacral Complications Following Long‐Segment Spinal Fusion in Adult Degenerative Scoliosis
ABSTRACT Purpose Long‐segment spinal fusions are associated with lumbosacral complications (LSC), but the associated risk factors are not known. This study aimed to identify the risk factors for LSC after long‐segment instrumented fusion with distal fixation to the L5 vertebral body in adult degener...
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| Format: | Article |
| Language: | English |
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Wiley
2025-01-01
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| Series: | Orthopaedic Surgery |
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| Online Access: | https://doi.org/10.1111/os.14275 |
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| author | Tinghua Jiang Xinuo Zhang Qingjun Su Xianglong Meng Aixing Pan Hanwen Zhang Yong Hai |
| author_facet | Tinghua Jiang Xinuo Zhang Qingjun Su Xianglong Meng Aixing Pan Hanwen Zhang Yong Hai |
| author_sort | Tinghua Jiang |
| collection | DOAJ |
| description | ABSTRACT Purpose Long‐segment spinal fusions are associated with lumbosacral complications (LSC), but the associated risk factors are not known. This study aimed to identify the risk factors for LSC after long‐segment instrumented fusion with distal fixation to the L5 vertebral body in adult degenerative scoliosis (ADS). Methods We retrospectively evaluated 294 patients with ADS who underwent long‐segment floating fusion between January 2014 and March 2022, with follow‐up for at least 2 years. Patients were matched to the baseline data using fusion level > 5 as a grouping variable. Patients who completed matching were divided into two groups according to the presence or absence of LSC. Univariate logistic regression was applied to identify potential risk factors for LSC, and multivariate logistic regression was used to identify independent risk factors for postoperative LSC. Results The overall incidence of LSC was 21.77% in the 294 patients, with disc degeneration in 28 (9.52%) and radiographic ASD in 44 (14.97%) patients. The mean time to LSC development after surgery was 26.91 ± 8.43 months. A total of 54 pairs of patients were matched and grouped, and the complication group had higher Oswestry Disability Index (ODI) and visual analog scale (VAS) scores at the last follow‐up. Multivariate analysis showed that gender (OR = 0.274, p = 0.026 [0.087, 0.859]); levels of fusion > 5 (OR = 3.127, p = 0.029 [1.120, 8.730]), main curve correction rate (OR = 0.009, p = 0.005 [0.000, 0.330]), and postoperative pelvic incidence minus lumbar lordosis (PI‐LL) > 15° (OR = 3.346, p = 0.022 [1.195, 9.373]) were independent risk factors for postoperative LSC. The area under the curve value of the prediction model was 0.804, with a 95% confidence interval of 0.715–0.892, indicating that the model had a high prediction accuracy. Collinearity statistics showed no collinearity between variables. Conclusion Sex, level of fusion > 5, main curve correction rate, and postoperative PI‐LL > 15° were independent risk factors for the development of LSC after long‐segment floating fusion. These results will improve our ability to predict personal risk conditions and provide better medical optimisation for surgery. |
| format | Article |
| id | doaj-art-021bf175fe604c01bc071bca29e36dc8 |
| institution | Kabale University |
| issn | 1757-7853 1757-7861 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Orthopaedic Surgery |
| spelling | doaj-art-021bf175fe604c01bc071bca29e36dc82025-01-16T05:31:15ZengWileyOrthopaedic Surgery1757-78531757-78612025-01-0117113314010.1111/os.14275Incidence and Risk Factors of Lumbosacral Complications Following Long‐Segment Spinal Fusion in Adult Degenerative ScoliosisTinghua Jiang0Xinuo Zhang1Qingjun Su2Xianglong Meng3Aixing Pan4Hanwen Zhang5Yong Hai6Department of Orthopedic Surgery, Beijing Chao‐Yang Hospital Capital Medical University Beijing ChinaDepartment of Orthopedic Surgery, Beijing Chao‐Yang Hospital Capital Medical University Beijing ChinaDepartment of Orthopedic Surgery, Beijing Chao‐Yang Hospital Capital Medical University Beijing ChinaDepartment of Orthopedic Surgery, Beijing Chao‐Yang Hospital Capital Medical University Beijing ChinaDepartment of Orthopedic Surgery, Beijing Chao‐Yang Hospital Capital Medical University Beijing ChinaDepartment of Orthopedic Surgery, Beijing Chao‐Yang Hospital Capital Medical University Beijing ChinaDepartment of Orthopedic Surgery, Beijing Chao‐Yang Hospital Capital Medical University Beijing ChinaABSTRACT Purpose Long‐segment spinal fusions are associated with lumbosacral complications (LSC), but the associated risk factors are not known. This study aimed to identify the risk factors for LSC after long‐segment instrumented fusion with distal fixation to the L5 vertebral body in adult degenerative scoliosis (ADS). Methods We retrospectively evaluated 294 patients with ADS who underwent long‐segment floating fusion between January 2014 and March 2022, with follow‐up for at least 2 years. Patients were matched to the baseline data using fusion level > 5 as a grouping variable. Patients who completed matching were divided into two groups according to the presence or absence of LSC. Univariate logistic regression was applied to identify potential risk factors for LSC, and multivariate logistic regression was used to identify independent risk factors for postoperative LSC. Results The overall incidence of LSC was 21.77% in the 294 patients, with disc degeneration in 28 (9.52%) and radiographic ASD in 44 (14.97%) patients. The mean time to LSC development after surgery was 26.91 ± 8.43 months. A total of 54 pairs of patients were matched and grouped, and the complication group had higher Oswestry Disability Index (ODI) and visual analog scale (VAS) scores at the last follow‐up. Multivariate analysis showed that gender (OR = 0.274, p = 0.026 [0.087, 0.859]); levels of fusion > 5 (OR = 3.127, p = 0.029 [1.120, 8.730]), main curve correction rate (OR = 0.009, p = 0.005 [0.000, 0.330]), and postoperative pelvic incidence minus lumbar lordosis (PI‐LL) > 15° (OR = 3.346, p = 0.022 [1.195, 9.373]) were independent risk factors for postoperative LSC. The area under the curve value of the prediction model was 0.804, with a 95% confidence interval of 0.715–0.892, indicating that the model had a high prediction accuracy. Collinearity statistics showed no collinearity between variables. Conclusion Sex, level of fusion > 5, main curve correction rate, and postoperative PI‐LL > 15° were independent risk factors for the development of LSC after long‐segment floating fusion. These results will improve our ability to predict personal risk conditions and provide better medical optimisation for surgery.https://doi.org/10.1111/os.14275adult degenerative scoliosislong floating fusionlumbosacral complicationsrisk factors |
| spellingShingle | Tinghua Jiang Xinuo Zhang Qingjun Su Xianglong Meng Aixing Pan Hanwen Zhang Yong Hai Incidence and Risk Factors of Lumbosacral Complications Following Long‐Segment Spinal Fusion in Adult Degenerative Scoliosis Orthopaedic Surgery adult degenerative scoliosis long floating fusion lumbosacral complications risk factors |
| title | Incidence and Risk Factors of Lumbosacral Complications Following Long‐Segment Spinal Fusion in Adult Degenerative Scoliosis |
| title_full | Incidence and Risk Factors of Lumbosacral Complications Following Long‐Segment Spinal Fusion in Adult Degenerative Scoliosis |
| title_fullStr | Incidence and Risk Factors of Lumbosacral Complications Following Long‐Segment Spinal Fusion in Adult Degenerative Scoliosis |
| title_full_unstemmed | Incidence and Risk Factors of Lumbosacral Complications Following Long‐Segment Spinal Fusion in Adult Degenerative Scoliosis |
| title_short | Incidence and Risk Factors of Lumbosacral Complications Following Long‐Segment Spinal Fusion in Adult Degenerative Scoliosis |
| title_sort | incidence and risk factors of lumbosacral complications following long segment spinal fusion in adult degenerative scoliosis |
| topic | adult degenerative scoliosis long floating fusion lumbosacral complications risk factors |
| url | https://doi.org/10.1111/os.14275 |
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