Article Figures & Data
Figures
- Figure
Kaplan–Meier plot showing 5-year reoperation-free survival following surgical management of L5 to S1 isthmic spondylolisthesis (P = 0.612). Dotted lines indicate 95% confidence interval.
Tables
- Table 1
Clinical characteristics of 1734 patients undergoing surgical treatment for L5 to S1 isthmic spondylolisthesis with minimum of 2-year follow-up.
Characteristic ALIF (n = 578) TLIF (n = 1156) P n % n % Age, y, mean ± SD 48.9 ± 13.1 49.1 ± 12.8 0.847 Sex, woman 325 56.3% 595 51.4% 0.087 Region Midwest 180 31.1% 458 39.5% 0.008 Northeast 98 17.0% 151 13.1% South 206 35.7% 349 30.2% West 94 16.2% 199 17.2% Comorbidities Charlson Comorbidity Index, mean ± SD 1.3 ± 1.6 1.3 ± 1.6 0.521 BMI 30–40 46 7.9% 106 9.1% 0.488 BMI 40+ 20 3.5% 62 5.4% 0.150 Smoke 132 22.8% 242 21.0% 0.841 Chronic pulmonary disease 122 21.1% 239 20.7% 0.872 Peripheral vascular disease 41 7.1% 73 6.3% 0.679 Diabetes mellitus 112 19.4% 264 22.8% 0.142 Hyperlipidemia 212 36.7% 467 40.4% 0.201 Hypertension 240 41.5% 539 46.6% 0.075 Hypothyroidism 98 17.0% 168 14.5% 0.245 Congestive heart failure 13 2.2% 22 1.9% 0.740 Coronary artery disease 48 8.3% 110 9.5% 0.497 Renal disease 23 4.0% 52 4.5% 0.748 Depression 179 31.0% 368 31.8% 0.764 Rheumatoid arthritis 19 3.3% 31 2.7% 0.618 Osteoporosis 76 13.1% 168 14.5% 0.592 Surgical details Access surgeon use 215 37.2% 0 0.0% - Allograft 276 47.8% 516 44.6% 0.263 Bone morphogenetic protein 52 9.0% 50 4.3% <0.001 Abbreviations: ALIF, anterior lumbar interbody fusion; BMI, body mass index; TLIF, transforaminal lumbar interbody fusion.
Note: Data presented as n and % unless otherwise noted. Boldface indicates statistical significance with P < 0.05.
- Table 2
Multivariate analysis of rates of 90-day medical complications by category for both groups.
Complication ALIF (n = 578) TLIF (n = 1156) Adjusted OR (95% CI) P n % n % Cardiopulmonary Arrhythmia 18 3.1% 47 4.0% 0.75 (0.39–1.36) 0.375 Myocardial infarction 0 0.0% 10 0.8% - - Cardiac arrest 1 0.2% 1 0.1% 3.02 (0.11–84.05) 0.455 Atelectasis 10 1.7% 25 2.2% 0.82 (0.33–1.83) 0.657 Respiratory failure 6 1.0% 10 0.8% 1.21 (0.36–3.66) 0.740 Pleural effusion 4 0.6% 2 0.2% 4.03 (0.62–33.88) 0.147 Pulmonary embolism 4 0.6% 6 0.5% 1.13 (0.23–4.69) 0.860 Deep vein thrombosis 2 0.4% 0 0.0% - - Central nervous system Cerebrovascular accident 2 0.4% 10 0.8% 0.58 (0.08–2.50) 0.515 Delirium 0 0.0% 2 0.2% - - Gastrointestinal Ileus 12 2.1% 6 0.5% 4.31 (1.50–14.13) 0.009 Bowel obstruction 2 0.4% 1 0.1% 3.49 (0.32–75.79) 0.310 Renal Electrolyte imbalance 2 0.4% 13 1.1% 0.34 (0.05–1.31) 0.172 Renal failure 10 1.7% 14 1.2% 1.39 (0.53–3.42) 0.477 Urinary retention 8 1.5% 12 1.0% 1.35 (0.52–3.32) 0.511 Infectious Pneumonia 8 1.5% 13 1.1% 1.50 (0.54–3.92) 0.406 Sepsis 2 0.4% 8 0.7% 0.52 (0.07–2.24) 0.432 Urinary tract infection 14 2.5% 31 2.7% 0.93 (0.44–1.83) 0.846 Total medical complications 107 18.5% 212 18.4% 1.01 (0.78–1.31) 0.923 No. of patients affected by medical complications 64 11.1% 124 10.7% 1.06 (0.76–1.48) 0.696 Abbreviations: ALIF, anterior lumbar interbody fusion; TLIF, transforaminal lumbar interbody fusion.
Note: Boldface indicates statistical significance with P < 0.05.
- Table 3
Multivariate analysis of rates of 90-day and 2-year surgical complications by category for both groups.
Complication ALIF (n = 578) TLIF (n = 1156) Adjusted OR (95% CI) P n % n % Operative Dural tear 5 0.8% 6 0.5% 1.88 (0.45–7.44) 0.360 Nerve root injury 0 0.0% 1 0.1% - - Vascular injury 3 0.5% 0 0.0% - - Visceral injury 0 0.0% 0 0.0% - - Transfusion 1 0.2% 2 0.2% 1.15 (0.05–13.09) 0.911 Neurological Nerve root motor deficit 12 2.1% 19 1.7% 1.22 (0.53–2.70) 0.618 Nerve root sensory deficit 7 1.2% 13 1.1% 1.24 (0.41–3.34) 0.677 Radiculopathy 18 3.1% 42 3.6% 0.86 (0.45–1.58) 0.655 Spinal cord deficit 1 0.2% 0 0.0% - - Cauda equina deficit 0 0.0% 1 0.1% - - Wound/Surgical Site Infection Wound dehiscence 7 1.2% 19 1.7% 0.75 (0.26–1.87) 0.559 Seroma 11 1.9% 16 1.3% 1.52 (0.61–3.67) 0.347 Hematoma 2 0.4% 5 0.4% 0.99 (0.13–5.17) 0.995 Deep wound infection 7 1.2% 30 2.6% 0.50 (0.18–1.18) 0.141 Superficial wound infection 0 0.0% 10 0.8% - - Mechanical/structural (2 y) Pseudarthrosis 22 3.7% 44 3.8% 0.95 (0.52–1.67) 0.867 Instrumentation failure 19 3.3% 40 3.4% 0.96 (0.51–1.75) 0.917 Vertebral body fracture 4 0.7% 14 1.2% 0.55 (0.15–1.51) 0.268 Reoperation 41 7.1% 89 7.7% 0.91 (0.59–1.39) 0.696 Total No. of surgical complications 182 31.4% 376 32.5% 0.95 (0.77–1.18) 0.671 No. of patients affected by surgical complications 86 14.9% 157 13.6% 1.17 (0.93–1.47) 0.170 Abbreviations: ALIF, anterior lumbar interbody fusion; TLIF, transforaminal lumbar interbody fusion.
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