1.Effect of screw loosening on health-related quality of life following single-level posterior lumbar interbody fusion: a retrospective study in Japan
Hiroki USHIROZAKO ; Tomohiko HASEGAWA ; Shigeto EBATA ; Tetsuro OHBA ; Hiroki OBA ; Keijiro MUKAIYAMA ; Yu YAMATO ; Go YOSHIDA ; Tomohiro BANNO ; Hideyuki ARIMA ; Shin OE ; Koichiro IDE ; Tomohiro YAMADA ; Kenta KUROSU ; Toshiyuki OJIMA ; Jun TAKAHASHI ; Hirotaka HARO ; Yukihiro MATSUYAMA
Asian Spine Journal 2026;20(2):244-254
Methods:
This study included 138 patients who underwent PLIF, with a mean age of 67 years and a follow-up period of 12 months. At 12 months postoperatively, lumbar computed tomography (CT) was performed to assess SL, and patients were categorized into SL and nonloosening (NL) groups accordingly. A propensity score-matched model was used to adjust for age, sex, and body mass index (BMI). Propensity score matching was performed to compare outcomes between the SL and NL groups.
Results:
Among the 138 patients, 29 (21%) developed SL following PLIF. Preliminary analysis revealed that the patients in the SL group were older and exhibited decreased femoral neck bone mineral density, preoperative pelvic retroversion, poor whole spine alignment, and lesser improvement in HRQOL compared with the NL group. Using propensity score matching, 22 patients were selected from each group (mean age, 72 years) (C-statistic=0.78). The propensity score-matched analysis demonstrated significant differences in the preoperative pelvic tilt (25.9° vs. 17.8°, p=0.010) between the matched SL and NL groups. Furthermore, the Oswestry Disability Index scores indicated poorer improvements in the matched SL group than in the matched NL group at 9 months postoperatively (p=0.025).
Conclusions
After matching, pre- and postoperative pelvic retroversion were significantly associated with SL. Patients with SL experienced significantly poorer improvement in HRQOL at 9 months postoperatively. Therefore, implementing strategies for preventing SL may enhance early postoperative HRQOL.
Result Analysis
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