Association between spinopelvic parameters and postoperative urinary retention in thoracolumbar spine surgery: a propensity-matched analysis
Abstract Postoperative urinary retention (POUR) is a frequent complication following spine surgery, with reported incidence rates ranging from 5 to 70%. While numerous risk factors have been identified, the relationship between spinopelvic parameters and POUR has not been previously investigated. Th...
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Nature Portfolio
2025-06-01
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| author | Jaenam Lee Kyung Soo Suk Byung Ho Lee Si Young Park Hak Sun Kim Seoung Hwan Moon Sub-ri Park Namhoo Kim Jae Won Shin Ji-Won Kwon |
| author_facet | Jaenam Lee Kyung Soo Suk Byung Ho Lee Si Young Park Hak Sun Kim Seoung Hwan Moon Sub-ri Park Namhoo Kim Jae Won Shin Ji-Won Kwon |
| author_sort | Jaenam Lee |
| collection | DOAJ |
| description | Abstract Postoperative urinary retention (POUR) is a frequent complication following spine surgery, with reported incidence rates ranging from 5 to 70%. While numerous risk factors have been identified, the relationship between spinopelvic parameters and POUR has not been previously investigated. This retrospective study examined the potential association between spinopelvic alignment and POUR in patients undergoing thoracolumbar spine surgery. We analyzed data from 420 patients who underwent surgery for degenerative thoracolumbar conditions between March 2021 and February 2024. After applying exclusion criteria and performing propensity score matching, 190 patients (95 with POUR, 95 without POUR) were included in the final analysis. Radiological parameters, including lumbar lordosis (LL), lower lumbar lordosis (LLL), pelvic tilt, sacral slope, and pelvic incidence, were assessed using preoperative and postoperative standing radiographs. Multivariable logistic regression analysis identified decreased preoperative LLL (< 27.77°) as an independent predictor of POUR (OR = 2.08, 95% CI = 1.10–3.91, p = 0.024). Additionally, higher intraoperative mean arterial pressure (> 75.35 mmHg) was associated with increased POUR risk (OR = 2.73, 95% CI = 1.08–6.88, p = 0.033). Our findings suggest that spinopelvic alignment, particularly decreased LLL, may play a previously unrecognized role in the development of POUR following thoracolumbar spine surgery. This novel association expands our understanding of POUR pathophysiology and could inform preoperative risk assessment and perioperative management strategies. Future prospective studies are warranted to validate these findings and explore the underlying mechanisms. |
| format | Article |
| id | doaj-art-cc533db7f96d4943b50fdf01e86fe470 |
| institution | DOAJ |
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| language | English |
| publishDate | 2025-06-01 |
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| series | Scientific Reports |
| spelling | doaj-art-cc533db7f96d4943b50fdf01e86fe4702025-08-20T03:22:02ZengNature PortfolioScientific Reports2045-23222025-06-011511910.1038/s41598-025-04127-9Association between spinopelvic parameters and postoperative urinary retention in thoracolumbar spine surgery: a propensity-matched analysisJaenam Lee0Kyung Soo Suk1Byung Ho Lee2Si Young Park3Hak Sun Kim4Seoung Hwan Moon5Sub-ri Park6Namhoo Kim7Jae Won Shin8Ji-Won Kwon9Department of Orthopedic Surgery, Yonsei University College of MedicineDepartment of Orthopedic Surgery, Yonsei University College of MedicineDepartment of Orthopedic Surgery, Yonsei University College of MedicineDepartment of Orthopedic Surgery, Yonsei University College of MedicineDepartment of Orthopedic Surgery, Yonsei University College of MedicineDepartment of Orthopedic Surgery, Yonsei University College of MedicineDepartment of Orthopedic Surgery, Yonsei University College of MedicineDepartment of Orthopedic Surgery, Yonsei University College of MedicineDepartment of Orthopedic Surgery, Yonsei University College of MedicineDepartment of Orthopedic Surgery, Yonsei University College of MedicineAbstract Postoperative urinary retention (POUR) is a frequent complication following spine surgery, with reported incidence rates ranging from 5 to 70%. While numerous risk factors have been identified, the relationship between spinopelvic parameters and POUR has not been previously investigated. This retrospective study examined the potential association between spinopelvic alignment and POUR in patients undergoing thoracolumbar spine surgery. We analyzed data from 420 patients who underwent surgery for degenerative thoracolumbar conditions between March 2021 and February 2024. After applying exclusion criteria and performing propensity score matching, 190 patients (95 with POUR, 95 without POUR) were included in the final analysis. Radiological parameters, including lumbar lordosis (LL), lower lumbar lordosis (LLL), pelvic tilt, sacral slope, and pelvic incidence, were assessed using preoperative and postoperative standing radiographs. Multivariable logistic regression analysis identified decreased preoperative LLL (< 27.77°) as an independent predictor of POUR (OR = 2.08, 95% CI = 1.10–3.91, p = 0.024). Additionally, higher intraoperative mean arterial pressure (> 75.35 mmHg) was associated with increased POUR risk (OR = 2.73, 95% CI = 1.08–6.88, p = 0.033). Our findings suggest that spinopelvic alignment, particularly decreased LLL, may play a previously unrecognized role in the development of POUR following thoracolumbar spine surgery. This novel association expands our understanding of POUR pathophysiology and could inform preoperative risk assessment and perioperative management strategies. Future prospective studies are warranted to validate these findings and explore the underlying mechanisms.https://doi.org/10.1038/s41598-025-04127-9Urinary retentionThoracolumbar spine surgeryRisk factorsLower lumbar lordosisSpinopelvic alignmentPost-void residual volume |
| spellingShingle | Jaenam Lee Kyung Soo Suk Byung Ho Lee Si Young Park Hak Sun Kim Seoung Hwan Moon Sub-ri Park Namhoo Kim Jae Won Shin Ji-Won Kwon Association between spinopelvic parameters and postoperative urinary retention in thoracolumbar spine surgery: a propensity-matched analysis Scientific Reports Urinary retention Thoracolumbar spine surgery Risk factors Lower lumbar lordosis Spinopelvic alignment Post-void residual volume |
| title | Association between spinopelvic parameters and postoperative urinary retention in thoracolumbar spine surgery: a propensity-matched analysis |
| title_full | Association between spinopelvic parameters and postoperative urinary retention in thoracolumbar spine surgery: a propensity-matched analysis |
| title_fullStr | Association between spinopelvic parameters and postoperative urinary retention in thoracolumbar spine surgery: a propensity-matched analysis |
| title_full_unstemmed | Association between spinopelvic parameters and postoperative urinary retention in thoracolumbar spine surgery: a propensity-matched analysis |
| title_short | Association between spinopelvic parameters and postoperative urinary retention in thoracolumbar spine surgery: a propensity-matched analysis |
| title_sort | association between spinopelvic parameters and postoperative urinary retention in thoracolumbar spine surgery a propensity matched analysis |
| topic | Urinary retention Thoracolumbar spine surgery Risk factors Lower lumbar lordosis Spinopelvic alignment Post-void residual volume |
| url | https://doi.org/10.1038/s41598-025-04127-9 |
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