Risk Factors for Adjacent Segment Disease in Short Segment Lumbar Interbody Fusion-A Case Series

被引:3
作者
Flores-Milan, Gabriel [1 ]
Cuello, Cesar Carballo [1 ]
Pressman, Elliot [1 ]
Marek, Jenna [1 ]
Krafft, Paul R. [1 ]
McBride, Paul [1 ]
Gassie, Kelly [1 ]
Hayman, Erik [1 ]
Alikhani, Puya [1 ,2 ]
机构
[1] Univ S Florida, Morsani Coll Med, Dept Neurosurg & Brain Repair, Tampa, FL USA
[2] Univ S Florida, Morsani Coll Med, Dept Neurosurg & Brain Repair, 2 Tampa Gen Circle, Tampa, FL 33606 USA
关键词
Adjacent segment disease; Case series; Interbody fusion; Lumbar lordosis; Pelvic incidence; Spinopelvic parameters; FACET JOINT VIOLATION; PELVIC INCIDENCE; DEGENERATION; LORDOSIS; SURGERY; ALIGNMENT; OUTCOMES;
D O I
10.1227/ons.0000000000000743
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
BACKGROUND: Adjacent segment disease (ASD) is a common problem after lumbar spinal fusions. Ways to reduce the rates of ASD are highly sought after to reduce the need for reoperation. OBJECTIVE: To find predisposing factors of ASD after lumbar interbody fusions, especially in mismatch of pelvic incidence and lumbar lordosis (PI-LL). METHODS: We conducted a retrospective cohort study of all patients undergoing lumbar interbody fusions of less than 4 levels from June 2015 to July 2020 with at least 1 year of follow-up and in those who had obtained postoperative standing X-rays. RESULTS: We found 243 patients who fit inclusion and exclusion criteria. Fourteen patients (5.8%) developed ASD, at a median of 24 months. Postoperative lumbar lordosis was significantly higher in the non-ASD cohort (median 46.4 degrees +/- 1.4 degrees vs 36.9 degrees +/- 3.6 degrees, P <.001), pelvic tilt was significantly lower in the non-ASD cohort (16.0 degrees +/- 0.66 degrees vs 20.3 degrees +/- 2.4 degrees, P =.002), PI-LL mismatch was significantly lower in the non-ASD cohort (5.28 degrees +/- 1.0 degrees vs 17.1 degrees +/- 2.0 degrees, P <.001), and age-appropriate PI-LL mismatch was less common in the non-ASD cohort (34 patients [14.8%] vs 13 [92.9%] of patients with high mismatch, P <.001). Using multivariate analysis, greater PI-LL mismatch was predictive of ASD (95% odds ratio CI = 1.393-2.458, P <.001) and ageappropriate PI-LL mismatch was predictive of ASD (95% odds ratio CI = 10.8-970.4, P <.001). CONCLUSION: Higher PI-LL mismatch, both age-independent and when adjusted for age, after lumbar interbody fusion was predictive for developing ASD. In lumbar degenerative disease, correction of spinopelvic parameters should be a main goal of surgical correction.
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收藏
页码:136 / 141
页数:6
相关论文
共 28 条
[1]   The PROCESS 2020 Guideline: Updating Consensus Preferred Reporting Of CasE Series in Surgery (PROCESS) Guidelines [J].
Agha, Riaz A. ;
Sohrabi, Catrin ;
Mathew, Ginimol ;
Franchi, Thomas ;
Kerwan, Ahmed ;
O'Neill, Niamh ;
Thoma, Achilles ;
Beamish, Andrew J. ;
Noureldin, Ashraf ;
Rao, Ashwini ;
Vasudevan, Baskaran ;
Challacombe, Ben ;
Perakath, Benjamin ;
Kirshtein, Boris ;
Ekser, Burcin ;
Pramesh, C. S. ;
Laskin, Daniel M. ;
Machado-Aranda, David ;
Pagano, Duilio ;
Roy, Gaurav ;
Kadioglu, Huseyin ;
Nixon, Iain J. ;
Mukhejree, Indraneil ;
McCaul, James A. ;
Ngu, James Chi-Yong ;
Albrecht, Joerg ;
Gomez Rivas, Juan ;
Raveendran, Kandiah ;
Derbyshire, Laura ;
Ather, M. Hammad ;
Thorat, Mangesh A. ;
Valmasoni, Michele ;
Bashashati, Mohammad ;
Chalkoo, Mushtaq ;
Teo, Nan Zun ;
Raison, Nicholas ;
Muensterer, Oliver J. ;
Bradley, Patrick James ;
Goel, Prabudh ;
Pai, Prathamesh S. ;
Afifi, Raafat Yahia ;
Rosin, Richard David ;
Coppola, Roberto ;
Klappenbach, Roberto ;
Wynn, Rolf ;
Surani, Salim ;
Giordano, Salvatore ;
Massarut, Samuele ;
Raja, Shahzad G. ;
Basu, Somprakas .
INTERNATIONAL JOURNAL OF SURGERY, 2020, 84 :231-235
[2]   Adjacent segment stenosis after lumbar fusion requiring second operation [J].
Aiki, H ;
Ohwada, O ;
Kobayashi, H ;
Hayakawa, M ;
Kawaguchi, S ;
Takebayashi, T ;
Yamashita, T .
JOURNAL OF ORTHOPAEDIC SCIENCE, 2005, 10 (05) :490-495
[3]   Adjacent segment degeneration after instrumented posterolateral lumbar fusion: a prospective cohort study with a minimum five-year follow-up [J].
Anandjiwala, Jigar ;
Seo, Jun-Yeong ;
Ha, Kee-Yong ;
Oh, In-Soo ;
Shin, Dong-Cheul .
EUROPEAN SPINE JOURNAL, 2011, 20 (11) :1951-1960
[4]   Adjacent Segment Degeneration After Lumbar Interbody Fusion With Percutaneous Pedicle Screw Fixation for Adult Low-Grade Isthmic Spondylolisthesis: Minimum 3 Years of Follow-up [J].
Bae, Jun Seok ;
Lee, Sang-Ho ;
Kim, Jin-Sung ;
Jung, Byungjoo ;
Choi, Gun .
NEUROSURGERY, 2010, 67 (06) :1600-1607
[5]   Spinopelvic Parameters: Lumbar Lordosis, Pelvic Incidence, Pelvic Tilt, and Sacral Slope What Does a Spine Surgeon Need to Know to Plan a Lumbar Deformity Correction? [J].
Celestre, Paul C. ;
Dimar, John R., II ;
Glassman, Steven D. .
NEUROSURGERY CLINICS OF NORTH AMERICA, 2018, 29 (03) :323-+
[6]   Does Percutaneous Lumbosacral Pedicle Screw Instrumentation Prevent Long-Term Adjacent Segment Disease after Lumbar Fusion? [J].
Changoor, Stuart ;
Faloon, Michael Joseph ;
Dunn, Conor John ;
Sahai, Nikhil ;
Issa, Kimona ;
Sinha, Kumar ;
Hwang, Ki Soo ;
Emami, Arash .
ASIAN SPINE JOURNAL, 2021, 15 (03) :301-307
[7]   Patient Outcomes Following Short-segment Lumbar Fusion Are Not Affected by PI-LL Mismatch [J].
Divi, Srikanth N. ;
Kepler, Christopher K. ;
Hilibrand, Alan S. ;
Goyal, Dhruv K. C. ;
Mujica, Victor E. ;
Radcliff, Kristen E. ;
Anderson, David Greg ;
Kurd, Mark F. ;
Rihn, Jeffrey A. ;
Kaye, Ian D. ;
Woods, Barrett R. ;
Vaccaro, Alexander R. ;
Schroeder, Gregory D. .
CLINICAL SPINE SURGERY, 2021, 34 (02) :73-77
[8]   A prospective randomised study on the long-term effect of lumbar fusion on adjacent disc degeneration [J].
Ekman, Per ;
Moller, Hans ;
Shalabi, Adel ;
Yu, Yiang Xiao ;
Hedlund, Rune .
EUROPEAN SPINE JOURNAL, 2009, 18 (08) :1175-1186
[9]  
Hilibrand Alan S, 2004, Spine J, V4, p190S, DOI 10.1016/j.spinee.2004.07.007
[10]   Radiculopathy and myelopathy at segments adjacent to the site of a previous anterior cervical arthrodesis [J].
Hilibrand, AS ;
Carlson, GD ;
Palumbo, MA ;
Jones, PK ;
Bohlman, HH .
JOURNAL OF BONE AND JOINT SURGERY-AMERICAN VOLUME, 1999, 81A (04) :519-528