Risk factors for adjacent segment disease requiring reoperation after posterior lumbar interbody fusion with screw fixation: focus on paraspinal muscle, ... View Full Text


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Article Info

DATE

2021-12-01

AUTHORS

Yeong Il Yun, Ikchan Jeon, Sang Woo Kim, Dongwoo Yu

ABSTRACT

PurposeAdjacent segment disease (ASD) requiring revision surgery is the most serious complication that can occur in patients undergoing posterior lumbar interbody fusion (PLIF) surgery. This study aimed to determine the risk factors for surgical ASD requiring revision surgery after PLIF with screw fixation surgery. We especially focused on paraspinal muscle, facet joint, and disc degeneration.MethodsAmong the patients who underwent PLIF with screw fixation due to degenerative spinal disease from January 2010 to December 2019, patients who underwent revision surgery for the development of ASD were enrolled. To evaluate the risk factors for surgical ASD, we selected a control group. Each patient in the control group was matched by age, sex, fusion level, number of fused segments, secondary MRI follow-up interval, and follow-up duration with a patient in the surgical ASD group. The radiographic and demographic data were compared between the surgical ASD and control groups.ResultsThere were statistically significant differences between the two groups in radiological parameters of preoperative facet degeneration, facet effusion, facet angle, and fatty degeneration of the multifidus muscle. Multivariable logistic regression analysis revealed that preoperative facet effusion (odds ratio [OR] 6.48), preoperative facet angle (OR 1.24), and progression of fatty degeneration in the multifidus muscle (OR 1.07) were significant risk factors for surgical ASD.ConclusionsPreexisting high-grade adjacent facet effusion, sagittally oriented facet joint angle, and progressive fatty degeneration of the multifidus muscle are associated with the development of surgical ASD after PLIF surgery. More... »

PAGES

913-922

References to SciGraph publications

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  • 2009-06-16. Risk factors for adjacent segment disease after lumbar fusion in EUROPEAN SPINE JOURNAL
  • 2020-04-03. Relationship between postoperative lordosis distribution index and adjacent segment disease following L4-S1 posterior lumbar interbody fusion in JOURNAL OF ORTHOPAEDIC SURGERY AND RESEARCH
  • 2014-09-12. Estimating the risk for symptomatic adjacent segment degeneration after lumbar fusion: analysis from a cohort of patients undergoing revision surgery in EUROPEAN SPINE JOURNAL
  • 2011-07-22. Adjacent segment degeneration after instrumented posterolateral lumbar fusion: a prospective cohort study with a minimum five-year follow-up in EUROPEAN SPINE JOURNAL
  • 2001-01-26. Correlation between sagittal plane changes and adjacent segment degeneration following lumbar spine fusion in EUROPEAN SPINE JOURNAL
  • 2011-09-20. Lumbar facet joint effusion in MRI: a sign of instability in degenerative spondylolisthesis? in EUROPEAN SPINE JOURNAL
  • 2014-10-12. Risk factors for predicting symptomatic adjacent segment degeneration requiring surgery in patients after posterior lumbar fusion in JOURNAL OF ORTHOPAEDIC SURGERY AND RESEARCH
  • 1999-05. MR imaging and CT in osteoarthritis of the lumbar facet joints in SKELETAL RADIOLOGY
  • 2001-05-16. Evaluation of the mobility of adjacent segments after posterior thoracolumbar fixation: a biomechanical study in EUROPEAN SPINE JOURNAL
  • 2009-10-30. Multifidus muscle changes and clinical effects of one-level posterior lumbar interbody fusion: minimally invasive procedure versus conventional open approach in EUROPEAN SPINE JOURNAL
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    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/34850289


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