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Jeffrey L. Gum, Steven D. Glassman, and Leah Y. Carreon

. A total of 722 patients with complete baseline and 1-year outcome measures following primary, instrumented, posterior lumbar fusion were identified. Patients who had fusion extending into the thoracic spine or that included pelvic fixation were excluded. The patients included had an average age of 60.8 ± 12.1 years with an average body mass index of 30.3 ± 12.1 kg/m 2 . Only 17.6% (n = 127) were smokers and 34.3% (n = 248) were males. Primary diagnosis included spondylolisthesis (n = 332, 46%), stenosis (n = 153, 21.2%), disc pathology (n = 146, 20

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screws. Failure-free survival rate was 92.5% at 1 year, 85.9% at 2 years, and 78.2% at 3 years. Failure was more common in patients with iliac bolts than those with S2AI screws (9 vs. 2; p=0.026). Four patients with iliac bolts developed nonunion at L5-S1. Placement of iliac bolts (OR 12.8, 95% CI [1.81, 191.42]), number of levels fused (1.6, [1.15, 2.40]), and age (0.9, [0.78, 0.97]) were significantly associated with failure. Reason for pelvic fixation, pelvic screw length, number of previous fusion operations, smoking, and use of BMP were not associated with