Investigating the Relationship Between High Density Lipoprotein Cholesterol and Fusion Outcomes Following Single Level Lumbar Fusion: A Propensity Matched Analysis.
retrospective_cohort · Level III
Where this comes from
- Record sourced from PubMed, PMID 42015881.
- Also identified by DOI 10.1177/21925682261443916 and PMC identifier 13102735.
- Licence recorded as CC BY-NC-ND.
- Because redistribution is not established, this page shows the abstract only. Follow the links below for the full text.
Abstract
Study DesignRetrospective cohort.ObjectivesAlthough dyslipidemia has been implicated in impaired bone healing, the role of high-density lipoprotein cholesterol (HDL-C) in spinal fusion outcomes remains poorly defined. Emerging evidence suggests that extremely elevated HDL-C levels may be associated with adverse osseous events. The objective of this study was to evaluate the association between HDL-C levels and rates of pseudoarthrosis and reoperation following single-level lumbar interbody fusion.MethodsThe TriNetX Research Network was queried for adult patients who underwent single level lumbar fusion during the 20-years period ended December 2, 2023. The high HDL-C cohort was designated by HDL-C ≥70.1 mg/dL, reflecting one standard deviation above the mean for all patients in the database. One standard deviation below the mean denoted the low HDL-C group (≤32.1 mg/dL). Propensity score matching was performed 1:1 according to demographics and comorbidities. Pseudoarthrosis diagnosis and reoperation were assessed at 6 months, 1 year, and 2 years postoperatively utilizing risk ratios (RR) and 95% confidence intervals (CI).ResultsAfter propensity matching, 1316 patient pairs were included. Patients with elevated HDL-C demonstrated significantly higher rates of pseudoarthrosis at 6 months, 1 year, and 2 years postoperatively. Early reoperation risk was also significantly increased in the high HDL-C cohort within 6 months, though differences were not sustained at later time points.ConclusionsElevated HDL-C was independently associated with increased risk of pseudoarthrosis following single-level lumbar fusion. These findings suggest that HDL-C may represent an underrecognized metabolic risk factor for impaired spinal fusion and warrants further investigation into underlying mechanisms and its possible utility in preoperative optimization programs.