• Anthony M Steinle, Wilson E Vaughan, Andrew J Croft, Alicia Hymel, Jacquelyn S Pennings, Hani Chanbour, Anthony Asher, Raymond Gardocki, Scott L Zuckerman, Amir M Abtahi, and Byron F Stephens.
• Department of Orthopedic Surgery, Vanderbilt University Medical Center, Nashville, TN.
• Spine. 2024 Feb 15; 49 (4): 232238232-238.

Study DesignRetrospective analysis on prospectively collected data.ObjectivesTo compare posterior lumbar fusions with versus without an interbody in: (1) Patient-reported outcomes (PROs) at 1 year and (2) postoperative complications, readmission, and reoperations.Summary Of Background DataElective lumbar fusion is commonly used to treat various lumbar pathologies. Two common approaches for open posterior lumbar fusion include posterolateral fusion (PLF) alone without an interbody and with an interbody through techniques, like transforaminal lumbar interbody fusion. Whether fusion with or without an interbody leads to better outcomes remains an area of active research.Patients And MethodsThe Lumbar Module of the Quality Outcomes Database was queried for adults undergoing elective primary posterior lumbar fusion with or without an interbody. Covariates included demographic variables, comorbidities, primary spine diagnosis, operative variables, and baseline PROs, including Oswestry Disability Index, North American Spine Society satisfaction index, numeric rating scale-back/leg pain, and Euroqol 5-dimension. Outcomes included complications, reoperations, readmissions, return to work/activities, and PROs. Propensity score matching and linear regression modeling were used to estimate the average treatment effect on the treated to assess the impact of interbody use on patient outcomes.ResultsAfter propensity matching, there were 1044 patients with interbody and 215 patients undergoing PLF. The average treatment effect on the treated analysis showed that having an interbody or not had no significant impact on any outcome of interest, including 30-day complications and reoperations, 3-month readmissions, 12-month return to work, and 12-month PROs.ConclusionThere were no discernible differences in outcomes between patients undergoing PLF alone versus with an interbody in elective posterior lumbar fusion. These results add to the growing body of evidence that posterior lumbar fusions with and without an interbody seem to have similar outcomes up to 1 year postoperatively when treating degenerative lumbar spine conditions.Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.

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