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Spontaneous Lumbar Interbody Fusion Following Posterolateral Fusion Surgery: A Retrospective Analysis of 5-Year Data

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Abstract

Background

Posterolateral fusion (PLF) surgery is frequently performed for a range of spinal disorders. However, spontaneous lumbar interbody fusion (SLIF) following PLF surgery is yet to be reported. Thus, we evaluated the incidence and characteristics of SLIF among patients that underwent PLF surgery.

Methods

This retrospective study involved review of electronic medical records of 121 adult patients who underwent primary lumbar decompression with instrumented PLF between 2006 and 2011. The available radiographs of L2–S1 region were assessed for SLIF and PLF. At 1 year, modified Lee’s and Lenke’s criteria were used to assess SLIF and PLF, respectively. Differences between the patients in the fusion and non-fusion groups were evaluated.

Results

At 1-year follow-up, 28.93 and 87.61% patients had SLIF and PLF, respectively. Moreover, 27.27% patients had both SLIF and PLF. L4–L5 (n = 13) was the most common segment involved in SLIF. SLIF rate was significantly greater among young adults (p value = 0.001), and those with no pre-operative instability (p value = 0.003) as well as who underwent pedicular fixation instrumented PLF surgery (p value < 0.0001). While, PLF was significantly greater in patients who did not undergo discectomy (p value = 0.049). SLIF was not significantly associated with sex, age groups, discectomy status, and level of PLF surgery (all p values > 0.05). PLF was not significantly associated with sex, age groups, pre-operative instability, type of instrumentation, and level of PLF surgery (all p values > 0.05). There was no significant association between patients with SLIF and PLF (p value = 0.155).

Conclusions

More than a quarter of patients developed SLIF and majority of them had PLF. SLIF was significantly associated with younger age at surgery and use of pedicular fixation instruments.

Level of Evidence III; retrospective cohort study.

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Data availability

Data cannot be shared openly but are available on reasonable request from the corresponding author.

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Acknowledgements

The authors would like to thank Dr. Vikas S. Sharma (MD), CEO, Maverick Medicorum® (India), for statistical analyses and medical writing assistance in the preparation of this article.

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Authors and Affiliations

  1. Department of Spine Surgery, Lilavati Hospital and Research Center, Bandra Reclamation Rd, General Arunkumar Vaidya Nagar, Bandra West, Mumbai, Maharashtra, 400050, India

    Tejasvi Agarwal, Shekhar Y. Bhojraj, Premik B. Nagad, Aaditya D. Kashikar, Mandar Borde, Gajendra Powal & A. Harikrishnan

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  1. Tejasvi Agarwal
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Contributions

TA—conceptualisation, design, methodology, interpretation of data, writing, review and editing, approval of the version to be published. SYB—conceptualisation, design, methodology, interpretation of data, writing, review and editing, approval of the version to be published. PBN—interpretation of data, writing, review and editing, approval of the version to be published. ADK—formal analysis, writing, review and editing, approval of the version to be published. MB—formal analysis, writing, review and editing, approval of the version to be published. GP—conceptualisation, design, methodology, interpretation of data, writing, review and editing, approval of the version to be published. HA—conceptualisation, design, methodology, interpretation of data, writing, review and editing, approval of the version to be published.

Corresponding author

Correspondence to Tejasvi Agarwal.

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The authors have no conflict of interest to declare.

Ethical Approval

The study was performed in line with the principles of the Declaration of Helsinki. Due to retrospective nature of the study, approval of the Institutional Ethics Committee was waived-off.

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As this was a retrospective record review, formal consent from patients was not required.

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Agarwal, T., Bhojraj, S.Y., Nagad, P.B. et al. Spontaneous Lumbar Interbody Fusion Following Posterolateral Fusion Surgery: A Retrospective Analysis of 5-Year Data. JOIO 58, 598–605 (2024). https://doi.org/10.1007/s43465-024-01148-w

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  • DOI: https://doi.org/10.1007/s43465-024-01148-w

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