Abstract
Purpose
To report upon surgical outcome in terms of adjacent segment changes after lumbosacral fusion and to analyze for risk factors indicating early surgical intervention for adjacent segment changes.
Material and Methods
This was a retrospective study of twenty patients who underwent revision surgery for adjacent segment changes after lumbosacral fusion. Inclusion criteria were as follows: 1) minimum 24 months follow- up, 2) confirmed adjacent segment changes by CT- myelogram or MRI, 3) conservative treatment for at least 3months, 4) available preoperative X-ray films and 5) posterolateral fusions at a prior fusion. Correlation analysis was performed for age, sex, the number of fused levels, grade of radiographic degeneration and instrumentation using the independent sample t- Test.
Results
A ge, sex, the number of fused levels, the use of instrumentation and the preservation of lumbar lordosis were not correlated with the interval to revision (IR). However, the grade of radiographic degeneration (plain film and CT) were highly correlated with IR (R= - 0.699, - 0.654). Degenerative scoliosis had a shorter IR, with statistical significance (P<0.05), than other disease examined. Excellent and good clinical results were obtained in 14 patients (60%), and solid bony fusion was achieved in 18 patients (90%).
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