Revision Surgery for Adjacent Segment Degeneration After Fusion for Lumbar Spondylolisthesis
| Autor: | Praveen V. Mummaneni, Dean Chou, Ping-Guo Duan, Rory R. Mayer, Chih-Chang Chang, Sigurd Berven, Huibing Ruan |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Male
Reoperation Adjacent segment medicine.medical_specialty medicine.medical_treatment Degeneration (medical) Correlation Lumbar interbody fusion Humans Medicine Orthopedics and Sports Medicine Lumbar spondylolisthesis Retrospective Studies Lumbar Vertebrae business.industry Retrospective cohort study Middle Aged medicine.disease Spondylolisthesis Surgery Spinal Fusion Treatment Outcome Spinal fusion Female Neurology (clinical) business |
| Zdroj: | Spine. 47:E10-E15 |
| ISSN: | 1528-1159 0362-2436 |
| DOI: | 10.1097/brs.0000000000003708 |
| Popis: | Study design Retrospective study. Objective The aim of this study was to investigate whether there is an association between revision surgery rates for adjacent segment degeneration (ASD) and Roussouly type after L4-5 transforaminal lumbar interbody fusion (TLIF) for spondylolisthesis. Summary of background data Revision surgery for ASD is known to occur after spinal fusion; however, it is unclear if rates of ASD are associated with certain Roussouly types. Methods Patients who underwent L4-5 TLIF for spondylolisthesis at the University of California San Francisco from January 2006 to December 2016 with minimum 2-year follow up were retrospectively analyzed by Roussouly type. Revision surgery for ASD was noted and correlated by Roussouly type. Spinopelvic parameters were also measured for correlation. A value of p Results There were 174 patients who met inclusion criteria, (59 males and 115 females). The average age was 62.3 (25-80) years. 132 patients had grade I spondylolisthesis, and 42 had grade II. Mean follow-up was 45.2 months (24 to 497). A total of 22 patients (12.6%) underwent revision surgery for ASD after L4-5 TLIF. When classified by Roussouly type, revision surgery rates for ASD were: 1, 14.3%; 2, 22.6%; 3, 4.9%; and 4, 15.6% (p = 0.013). Type 3 spines with normal PI-LL (8.85° ± 6.83°) had the lowest revision surgery rate (4.9%), and type 2 spines with PI-LL mismatch (11.06° ± 8.81°) had the highest revision surgery rate (22.6%), a 4-fold difference (p = 0.013). The PI-LL mismatch did not change significantly in each type post-operatively (p > 0.05). Conclusion We found that there may be a correlation between Roussouly type and revision surgery for ASD after L4-5 TLIF for spondylolisthesis, with type 2 spines having the highest rate. Spinopelvic parameters may also correlate with revision surgery for ASD after L4-5 TLIF. Level of evidence 4. |
| Databáze: | OpenAIRE |
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