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. 2025 Jul 29;9(8):e24.00304.
doi: 10.5435/JAAOSGlobal-D-24-00304. eCollection 2025 Aug 1.

Patients With Cystic Fibrosis Undergoing Posterior Lumbar Fusion Are at an Increased Odds of Perioperative Complications

Scott J Halperin  1 , Meera M Dhodapkar, Michael J Gouzoulis, Arya Varthi, Daniel R Rubio, Jonathan N Grauer
Affiliations

Patients With Cystic Fibrosis Undergoing Posterior Lumbar Fusion Are at an Increased Odds of Perioperative Complications

Scott J Halperin et al. J Am Acad Orthop Surg Glob Res Rev. .

Abstract

Introduction: Perioperative outcomes for patients with cystic fibrosis (CF) have not been previously described following spine surgery. This study used PearlDiver to examine the 90-day postoperative outcomes and 4-year revision rates after posterior lumbar fusion (PLF) for patients with CF compared with matched controls.

Methods: This study examined a cohort of PLF patients with versus without CF. Patients were matched 1:10 for age, sex, Elixhauser Comorbidity Index, and the number of levels. Ninety-day postoperative outcomes and 4-year revision rates were compared.

Results: One hundred twenty-seven patients with CF were matched with 1263 controls without CF. On multivariable logistic regression, those with CF had statistically significantly increased 90-day odds of the following: venous thromboembolism (odds ratio [OR], 4.2), pleural effusion (OR, 3.4), dyspnea (OR, 3.2), respiratory failure (OR, 2.8), pneumonia (OR, 2.6), acute kidney injury (OR, 2.4), hospital readmissions, (OR, 2.2), and emergency department visits (OR, 2.1). Notably, patients with CF were not at increased odds of 4-year subsequent lumbar surgery.

Discussion: Patients with CF were at significantly increased odds of pulmonary and other defined adverse events. These findings are pertinent in the perioperative risk assessment, patient/family recommendations, and surgical preparations for patients with CF being considered for PLF.

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Figures

Figure 1
Figure 1
Forest plot showing the odds ratios and 95% confidence intervals for the 90-day postoperative outcomes and 4-year subsequent lumbar surgery rates.
See this image and copyright information in PMC

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