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Abstract
Objective
To compare patients who underwent spinal revision surgery of adjacent segment degeneration with above one and above two vertebral segment preceded by initial spinal fusion surgery.
Summary of Literature Review
The adjacent segment disease(ASD) occurs more frequently at the more proximal segment of the spinal fusion. Also, the preexisting degenerative segments (with discs or facet joints) not included in the fusion procedure, fusion segmental sagittal angle, fixed appliances method, gender, and age, have been accepted as the causes.
Materials and Methods
The patients were watched over a year after the spinal revision operation followed by initial spinal fusion of single or multiple segments; the subjects were limited to 41 patients. The average age, entity of diseases, average duration between the initial spinal fusion and the revision surgery, multiple clinical and radiographic parameters were evaluated and compared.
Results
Using the UCLA grade of intervertebral disc degeneration, the average grade of 1 level upper segment was 2.2 in group A and 1.9 in group B without statistical significance(p=0.426). However, the average grade of 2-level upper segment was 1.8 in group A and 2.4 in group B with significant difference(p=0.021). There was no statistical difference in other factors between the two groups.
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Table 1.
Patient Demographics
Table 2.
University of California at Los Angeles Grading (UCLA) for Inte vertebral Space Degeneration
| Grade | Disc-Space Narrowing | Osteophytes | End plate Sclerosis |
|---|---|---|---|
| I | - | - | - |
| II | + | - | - |
| III | ± | + | - |
| IV | ± | ± | + |
Table 3.
Weishaupt's Grading for Facet Degeneration
Table 4.
Disk Degeneration Grade. Average of A Group : B Group
Table 5.
Radiologic Parameters (measurement of degrees except millimeters in disc height, p value of all parameters>0.05)
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