Pseudarthrosis risk factors in lumbar fusion: a systematic review and meta-analysis
Issued Date
2024-06-03
Resource Type
eISSN
14712474
Scopus ID
2-s2.0-85195018169
Pubmed ID
38831392
Journal Title
BMC musculoskeletal disorders
Volume
25
Issue
1
Rights Holder(s)
SCOPUS
Bibliographic Citation
BMC musculoskeletal disorders Vol.25 No.1 (2024) , 433
Suggested Citation
Boonsirikamchai W., Wilartratsami S., Ruangchainikom M., Korwutthikulrangsri E., Tongsai S., Luksanapruksa P. Pseudarthrosis risk factors in lumbar fusion: a systematic review and meta-analysis. BMC musculoskeletal disorders Vol.25 No.1 (2024) , 433. doi:10.1186/s12891-024-07531-w Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/98686
Title
Pseudarthrosis risk factors in lumbar fusion: a systematic review and meta-analysis
Author's Affiliation
Corresponding Author(s)
Other Contributor(s)
Abstract
This study presents a systematic literature review and meta-analysis of pseudarthrosis risk factors following lumbar fusion procedures. The odds ratio (OR) and 95% confidence interval (95% CI) were used for outcome measurements. The objective of this study was to identify the independent risk factors for pseudarthrosis after lumbar spinal fusion, which is crucial for mitigating morbidity and reoperation. Systematic searches in PubMed, Embase, and Scopus (1990-July 2021) were conducted using specific terms. The inclusion criteria included prospective and retrospective cohorts and case‒control series reporting ORs with 95% CIs from multivariate analysis. The quality assessment utilized the Newcastle-Ottawa scale. Meta-analysis, employing OR and 95% CI, assessed pseudarthrosis risk factors in lumbar fusion surgery, depicted in a forest plot. Of the 568 abstracts identified, 12 met the inclusion criteria (9 retrospective, 2006-2021). The 17 risk factors were categorized into clinical, radiographic, surgical, and bone turnover marker factors. The meta-analysis highlighted two significant clinical risk factors: age (95% CI 1.02-1.11; p = 0.005) and smoking (95% CI 1.68-5.44; p = 0.0002). The sole significant surgical risk factor was the number of fused levels (pooled OR 1.35; 95% CI 1.17-1.55; p < 0.0001). This study identified 17 risk factors for pseudarthrosis after lumbar fusion surgery, emphasizing age, smoking status, and the number of fusion levels. Prospective studies are warranted to explore additional risk factors and assess the impact of surgery and graft type.