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Surgical Approach and Complications of Stand-alone Lateral Trans-Psoas Interbody Fusion
Published on: February 14, 2025
[Prognostic factors for post surgical complications in bone infection and pseudarthrosis]
A Cicero-Álvarez1, S R León-Hernández2, K Gutiérrez-Enríquez3
1Servicio de Infecciones Óseas y Seudoartrosis. Instituto Nacional de Rehabilitación «Luis Guillermo Ibarra Ibarra». Calzada México-Xochimilco Núm. 289, Col. Arenal de Guadalupe, CP 14389, Del. Tlalpan, Ciudad de México.
Abstract:
Bone infection and nonunion are the main orthopedic and traumatic complications whose treatment remains a challenge because multiple factors are involved in the rate of failures when you try to correct them. Knowing these factors were the problem that caused the research through a prospective longitudinal study of 83 patients of 43.3 ± 16.1 years old. They were treated for aseptic and septic nonunion, osteomyelitis, osteitis, malunion or infected joint replacement. The cases were classified with or without postoperative complications and outcome related to systemic and local factors taken prognostic model Cierny-Mader as factors affecting immune surveillance, metabolism and local vascularization. For bivariate analysis of data Χ² it was applied or where appropriate Fishers exact test; for multivariate analysis model not conditional binary logistic regression method was applied Wald backward to select the significant prognostic factors. The alpha error was set 0.05. General complications occurred in 51.8% of cases. Local factors (lymphedema, arteritis, venous insufficiency, loss of skin) with an OR of 5.0 (95% CI 1.0-24.9, p = 0.03), septic nonunion with OR of 5.0 (95% CI 1.9-13.0, p = 0.001) and segmental fractures with an OR of 3.2 (95% CI 0.8-13.0, p = 0.07) were the prognostic factors identified in the bivariate analysis; however, the logistic regression only selected as the septic pseudoarthrosis as a significant factor. It is necessary to detect and if necessary control or eliminate those factors that can directly affect poor postoperative results.
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