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High fusion rates found with axial interbody arthrodesis of the L5-S1 segment
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Based primarily on Level 3 and 4 studies that were conducted by authors with conflicts of interest, a review of the literature shows axial interbody fusion performed at the lumbrosacral junction had a 12.9% complication rate and a 93.15% fusion rate.
Researchers conducted a systematic search of MEDLINE for all-peer reviewed articles between Jan. 1, 2000 and Aug. 17, 2014 related to the fusion rate of L5-S1 and the safety profile of axial interbody arthrodesis. Although 74 cases were found, 15 case series met the inclusion criteria for the study.
The series included 700 patients. The overall pseudarthrosis rate at L5-S1 was 6.9% and the overall complications rate, excluding pseudarthrosis, was 12.9%. About 14.4% of patients required another surgery, researchers noted, and the infection rate was 5.44%.
Researchers wrote that industry-sponsored studies or those in which authors had a conflict of interest reported a 12.4% complication rate compared with a 17.8% rate for studies with no conflict of interest. They concluded that as their results are based mainly on retrospective studies by authors with conflicts of interest, actual fusion rates may be lower and complication rates may be higher. – by Robert Linnehan
Disclosures: Schroeder reports receiving travel support from Medtronic. Please see the full study for a list of all other authors’ relevant financial disclosures.
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