Risk factors affecting the fusion in the lumbar spine instability treatmentOBJECTIVE: to describe the risk factors that affect the vertebral fusion in the lumbar spine instability, in patients attended in our hospital that are related to nutritional aspects. METHODS: A total of 59 patients were reviewed of whom 15 (25.4%) were cases (pseudoartrosis), and 44 (74.6%) were controls (fusion). The population distribution presented patients, of which 27 (45.8%) were female and 32 (54.2%), male. The average age was 51 with a 12 standard deviation, a minimum of 20 and a maximum of 85 years old. Distribution by diagnosis was 29 (49.1%) spondylolisthesis, 21 (35.6%) fractures, 5 (8.5%) herniations, 3 (5.1%) infections, and 1 (1.7%) tumor. The average weight was 75.9 kg, with 1.60 cm height, BMI of 24.5, a Hb of 15.2, Hto of 35.9, and 3.5 albumin. RESULTS: several risk factors were analyzed between ages higher than 60 years, it showed a 49% more likely to a pseudoartrosis in comparison with the Control Group with a 95% CI=0.12-2.27. More than 90 kg of weight showed 82% more likely to a pseudoartrosis in comparison with the Fusion Group, having as a 95% CI=0.03-0.43, the BMI shows 25% more likely to a pseudoartrosis with a 95% CI=0.18-3.18, hypoalbuminemia less than 3.4 mg/100 mL showed a 78% more likely to the pseudoartrosis (95% CI=0.06-0.75). CONCLUSIONS: the pseudoartrosis is caused by risk factors associated with the nutrient profile, like the obesity itself, the hypoalbuminemia and there is a probability to present 1.5 times more than the values of ordinary people. Thus, it is important that these values are evaluated and fixed before in the pre-surgical with support measures that allows adequate metabolic and, consequently, an optimal outcome, such as fusion. EVIDENCE LEVEL: study case-control with a level III of evidence.
Joint instability; Lumbar vertebrae; Risk factors; Spinal fusion
