Evidence map›Paper›PMID 41923657›Full record

ArticleOrthopaedic surgery2026

Risk Factors and Clinical Significance for Retrolisthesis of Adjacent Segment After Transforaminal Lumbar Interbody Fusion.

Zhongmao Xu, Qinghua Zhao, Bin Wang, Zezhang Zhu, Yong Qiu, Xu Sun

Abstract read
In one paragraph

Article in Orthopaedic surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

6 authors.

Zhongmao XuDivision of Spine Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China.ORCID https://orcid.org/0009-0005-8556-8002
Qinghua ZhaoDivision of Spine Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China.ORCID https://orcid.org/0000-0003-2553-3762
Bin WangDivision of Spine Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China.
Zezhang ZhuDivision of Spine Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China.ORCID https://orcid.org/0000-0001-8569-3595
Yong QiuDivision of Spine Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China.
Xu SunDivision of Spine Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China.

Funding

Development Project of Nanjing Science and Technology Commission and Foundation ZKX20020Jiangsu Provincial Medical Innovation Center of Orthopedic Surgery CXZX202214
6 · The paper itself

Abstract

objectiveAdjacent segment retrolisthesis is a common yet frequently overlooked complication after lumbar fusion, which may lead to reoperation. However, its risk factors, particularly those related to preoperative degenerative status and intraoperative variables, remain poorly understood. Therefore, this study aimed to elucidate the risk factors that contribute to the development of retrolisthesis in the adjacent segment following transforaminal lumbar interbody fusion (TLIF).

methodsWe retrospectively reviewed 473 patients who underwent lower lumbar fusion for degenerative diseases from June 2017 to September 2022, with a minimum follow-up of 2 years. Seventy patients who developed radiographic retrolisthesis postoperatively were included in the RR group, and 18 patients with symptoms were classified into the symptomatic retrolisthesis (SR) group. Using a 1:2 ratio, 140 patients without retrolisthesis were matched as the non-retrolisthesis (NR) group. Preoperative MRI was used to assess fat infiltration and cross-sectional area of the erector spinae, multifidus, and psoas muscles, as well as total endplate score and disc degeneration. CT was used to evaluate facet degeneration and pedicle screw-related facet joint violation. Independent sample t-tests and chi-square tests were used for group comparisons, and multivariate logistic regression analysis was performed to identify independent risk factors.

resultsBaseline age, sex, and bone mineral density were comparable between groups. Multivariate analysis showed that higher preoperative total endplate score (OR 2.086, 95% CI 1.496-2.907, p < 0.001), greater paraspinal muscle fat infiltration (OR 1.117, 95% CI 1.046-1.192, p = 0.001), facet degeneration (OR 2.838, 95% CI 1.762-4.570, p < 0.001), and postoperative facet violation (OR 1.911, 95% CI 1.330-2.746, p = 0.001) were independent risk factors for RR. Predictors of SR included total endplate score (OR 3.506, p = 0.002), fat infiltration of paraspinal muscles (OR 1.230, p = 0.008), facet degeneration (OR 8.940, p = 0.002), and postoperative facet violation (OR 2.873, p = 0.024).

conclusionPreoperative degeneration of adjacent endplates, facet joints, and paraspinal muscles, together with postoperative facet joint violation, appears to be significantly associated with the development of retrolisthesis. Patients with retrolisthesis often present with persistent or severe low back pain after lumbar fusion, resulting in impaired quality of life.

Indexed as

Lumbar VertebraePostoperative ComplicationsSpinal FusionAdultAgedFemaleHumansIntervertebral Disc DegenerationMaleMiddle AgedRetrospective StudiesRisk Factorsadjacent segment diseasefacet jointparaspinal musclesretrolisthesistransforaminal lumbar interbody fusion

Identifiers

PMID41923657
PMCPMC13138899

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.