Journal of Korean Neurosurgical Society

The Korean Neurosurgical Society (대한신경외과학회)
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Symptomatic Adjacent Segment Degeneration Following Posterior Lumbar Arthrodesis : Retrospective Analysis of 26 Patients Experienced in. 10-year of Periods

  • Shin, Myung-Hoon (Department of Neurosurgery Kangnam St. Mary's Hospital The Catholic University of Korea) ;
  • Ryu, Kyeong-Sik (Department of Neurosurgery Kangnam St. Mary's Hospital The Catholic University of Korea) ;
  • Kim, Il-Sup (Department of Neurosurgery Kangnam St. Mary's Hospital The Catholic University of Korea) ;
  • Park, Chun-Kun (Department of Neurosurgery Kangnam St. Mary's Hospital The Catholic University of Korea)
  • Published : 2007.09.28
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Abstract

Objective : The authors retrospectively analyzed clinical and radiographic features of patients who developed symptomatic adjacent segment degeneration (ASD) that required re-operation. Methods : From 1995 to 2004, among 412 patients who underwent posterior lumbar fusion surgery, the authors experienced twenty-six patients who presented symptomatic ASD. Records of these patients were reviewed to collect clinical data at the first and second operations. Results : The patients were 9 males and 17 females whose mean age was $63.5{\pm}8.7$ years. Among 319 one segment and 102 multi-segment fusions, 16 and 10 patients presented ASD, respectively. Seventeen ASDs were noticed at the cephalad to fusion (65%), eight at the caudad (31%), and one at the cephalad and caudad, simultaneously (4%). All patients underwent decompression surgery. Nine patients underwent additional fusion surgeries to adjacent degenerated segments. In 17 patients who underwent only decompression surgery without fusion, the success rate was 82.4%. In fusion cases. the success rate was observed as 55.5%. There were no statistically significant factors to be related to development of ASD. However, in cases of multi-level fusion surgery, there was a tendency toward increasing ASD. Conclusion : Multi-segment fusion surgery could be associated with a development of ASD. In surgical treatment of symptomatic ASD, selective decompression without fusion may need to be considered as a primary procedure, which could reduce the potential risk of later occurrence of the other adjacent segment disease.

Keywords

References

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