The risk factors for low back pain following oblique lateral interbody fusion: focus on sarcopenia.

IF 2.8 3区医学 Q1 ORTHOPEDICS Journal of Orthopaedic Surgery and Research Pub Date : 2025-02-17 DOI:10.1186/s13018-025-05584-8

Dazhuang Miao, Mengke Fan, Weiqi Zhang, Xiaowei Ma, Hui Wang, Xianda Gao, Di Zhang

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Abstract

Background: Sarcopenia had been identified as a factor influencing the postoperative outcomes of lumbar surgery. The effect of sarcopenia on the surgical outcomes in patients who underwent oblique lateral interbody fusion (OLIF) had not yet been examined.

Objective: The aim of our study was to investigate the association between sarcopenia and postoperative low back pain (LBP) in patients following OLIF and provide recommendations for surgical strategy.

Methods: 116 patients who underwent OLIF were retrospectively reviewed. Patients were classified into sarcopenia group (Group SP) and non-sarcopenia group (Group NSP). According to whether instruments was performed, Group SP was further divided into OLIF stand-alone group (Group SP-SA) and OLIF with instruments group (Group SP-IN). The patient characteristics, surgical data and questionnaire scores were collected. Oswestry Disability Index (ODI) score was used to evaluate lumbar function and pain intensity. Multivariable logistic regression analysis was used to identify the risk factors for postoperative LBP.

Results: There were 38 patients in Group SP and 78 patients in Group NSP. The incident rare of osteoporosis in Group SP was higher than that in Group NSP (P = 0.012). In Group SP, last follow-up intervertebral height (IH) was lower (P = 0.045) and incident rate of cage subsidence was higher ((P = 0.044). No significant difference (P = 0.229) showed in preoperative ODI scores, however, last follow-up ODI scores in Group SP was significantly higher (P = 0.017) than that in Group NSP. Multivariable logistic regression analysis showed that sarcopenia (P = 0.004), osteoporosis (P = 0.012) and cage subsidence (P = 0.002) were identified as risk factors for postoperative LBP. In Group SP-IN, last follow-up ODI score (P = 0.024) and incident rate of cage subsidence (P = 0.027) were significantly lower Compared to Group SP-SA.

Conclusions: LBP was a common complication following OLIF with the incidence rate of 18.1%. Sarcopenia, osteoporosis and cage subsidence were risk factors for LBP following OLIF. Instruments effectively reduced the incidence and degree of postoperative LBP in patients with sarcopenia following OLIF. Consequently, we suggest incorporating supplementary instruments for patients with sarcopenia in surgical strategy.

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斜侧椎间融合术后腰痛的危险因素：关注肌肉减少症。

背景：肌肉减少症已被确定为影响腰椎手术术后预后的一个因素。肌减少症对斜侧体间融合术（OLIF）患者手术结果的影响尚未被研究。目的：本研究旨在探讨OLIF患者肌肉减少症与术后腰痛（LBP）之间的关系，并为手术策略提供建议。方法：对116例行OLIF的患者进行回顾性分析。患者分为肌少症组（SP组）和非肌少症组（NSP组）。根据是否使用器械，SP组进一步分为OLIF单机组（SP- sa组）和OLIF联合器械组（SP- in组）。收集患者特征、手术资料及问卷评分。Oswestry残疾指数（ODI）评分用于评估腰椎功能和疼痛强度。采用多变量logistic回归分析确定术后腰痛的危险因素。结果：SP组38例，NSP组78例。SP组骨质疏松发生率高于NSP组（P = 0.012）。SP组末次随访椎间高度（IH）较低（P = 0.045），鼠笼下沉发生率较高（P = 0.044）。术前ODI评分差异无统计学意义（P = 0.229），但SP组末次随访ODI评分显著高于NSP组（P = 0.017）。多变量logistic回归分析显示，肌肉减少症（P = 0.004）、骨质疏松症（P = 0.012）和笼型下沉（P = 0.002）是术后腰痛的危险因素。SP-IN组的末次随访ODI评分（P = 0.024）和笼沉降发生率（P = 0.027）均显著低于SP-SA组。结论：腰痛是OLIF术后常见的并发症，发生率为18.1%。肌少症、骨质疏松和笼型下沉是OLIF术后腰痛的危险因素。器械可有效降低OLIF术后肌肉减少患者腰痛的发生率和程度。因此，我们建议在手术策略中加入肌肉减少症患者的辅助器械。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Orthopaedic Surgery and Research ORTHOPEDICS-

CiteScore

4.10

自引率

7.70%

发文量

494

审稿时长

>12 weeks

期刊介绍： Journal of Orthopaedic Surgery and Research is an open access journal that encompasses all aspects of clinical and basic research studies related to musculoskeletal issues. Orthopaedic research is conducted at clinical and basic science levels. With the advancement of new technologies and the increasing expectation and demand from doctors and patients, we are witnessing an enormous growth in clinical orthopaedic research, particularly in the fields of traumatology, spinal surgery, joint replacement, sports medicine, musculoskeletal tumour management, hand microsurgery, foot and ankle surgery, paediatric orthopaedic, and orthopaedic rehabilitation. The involvement of basic science ranges from molecular, cellular, structural and functional perspectives to tissue engineering, gait analysis, automation and robotic surgery. Implant and biomaterial designs are new disciplines that complement clinical applications. JOSR encourages the publication of multidisciplinary research with collaboration amongst clinicians and scientists from different disciplines, which will be the trend in the coming decades.