Analysis Of Risk Factors Of Failed Back Surgery Syndrome After PLIF

【Objective】Observe the incidence of failed back surgery syndrome after Posterior Lumbar Interbody Fusion（PLIF）,and explore the related risk factors of failed back surgery syndromein patients.【Methods】Retroretrospective analysis of the clinical data of patients diagnosed with PLIF in the First Affiliated Hospital of Dali University from January 2019 to January 2021.All the patients included in the study had clear diagnosis,perfect case data and underwent operation in the same medical group.the follow-up time was 12 to 35 months,with an average follow-up of 20.3 months.according to the definition of lumbar surgery failure syndrome,the patients were divided into two groups: the case group and the control group.The patients with lumbar postoperative syndrome（FBSS）were divided into two groups:the case group and the control group.The data were collected and analyzed,including the age,sex,complicated with hyperuricemia,history of hypertension,history of diabetes,operation time and external fixation time of patients,The variables with P value less than0.05 in the above single factor analysis were included in the multivariate logistic analysis,and the ratio ratio（OR）and 95% confidence interval（CI）of the variables were recorded.All data were analyzed and processed by SPSS26.0 software.【Results】A total of 176 patients were included,including 28 patients with lumbar surgery failure syndrome,and the incidence of lumbar surgery failure syndrome was 15.9%.Univariate analysis of the relevant data between the FBSS group and the control group:there was no significant difference in age,sex,complicated with hyperuricemia,history of hypertension,history of diabetes,operation time and external fixation time between the two groups（P > 0.05）.There were significant differences in the course of disease,scar constitution,intraoperative blood loss and first landing time between the two groups（P <0.05）,which was considered to be related to the occurrence of FBSS.The data with statistical significance in univariate analysis were included in multivariate logistic analysis:At the duration of the disease course（OR: 7.288,95%CI:1.787-29.728P=0.006）,scar constitution（OR: 5.632,95%CI:1.765-17.971,P=0.004）,intraoperative bleeding volume（OR: 1.003,95%CI:1.001-1.006,P=0.017）,First landing time（OR: 2.837,95%CI:1.092-7.369,P=0.032）and other four factors are independent risk factors for lumbar surgical failure syndrome following single-stage.【Conclusion】1.The independent risk factors for FBSS were: disease duration of more than 1 year,scar constitution,excessive intraoperative bleeding,and time to first landing of more than3 days;2.There was no correlation between the occurrence of FBSS and the patient’s own age,sex,BMI,smoking and drinking history,hyperuricemia,hypertension history,diabetes history,surgery time and external fixation time;3.According to the results of this study,in clinical work,the surgical team doctor should pay more attention to the occurrence of postoperative FBSS and take effective preventive measures and timely preoperative communication.If the patient has excessive blood loss during surgery or the first postoperative time,the doctor should give symptomatic treatment and specify postoperative.