106. Adjacent Segment Disease Following Posterior Instrumentation and Fusion for Degenerative Lumbar Scoliosis

2007 ◽  
Vol 7 (5) ◽  
pp. 52S
Author(s):  
Kyu Jung Cho ◽  
Se-Il Suk ◽  
Jin-Hyok Kim ◽  
Young-Hyun Yun
Keyword(s):  
Posterior Instrumentation ◽  
Adjacent Segment Disease ◽  
Adjacent Segment ◽  
Degenerative Lumbar Scoliosis ◽  
Lumbar Scoliosis

scholarly journals Adjacent Segment Disease After Posterior Lumbar Interbody Fusion: A Case Series of 1000 Patients

2018 ◽  
Vol 8 (7) ◽  
pp. 722-727 ◽  
Author(s):  
Shinya Okuda ◽  
Tomoya Yamashita ◽  
Tomiya Matsumoto ◽  
Yukitaka Nagamoto ◽  
Tsuyoshi Sugiura ◽  
...  
Keyword(s):  
Interbody Fusion ◽  
Degenerative Spondylolisthesis ◽  
Posterior Lumbar Interbody Fusion ◽  
Adjacent Segment Disease ◽  
Adjacent Segment ◽  
Degenerative Lumbar Scoliosis ◽  
Lumbar Interbody Fusion ◽  
Time Period ◽  
Time Periods

Study Design: Retrospective study. Objective: There have been few reports of adjacent segment disease (ASD) after posterior lumbar interbody fusion (PLIF) with large numbers and long follow-up. The purpose of this study was to investigate (1) ASD incidence and time periods after primary PLIF, (2) repeat ASD incidence and time periods, and (3) ASD incidence and time periods by fusion length, age, and preoperative pathologies. Methods: A total of 1000 patients (average age 67 years, average follow-up 8.3 years) who underwent PLIF for degenerative lumbar disorders were reviewed. ASD was defined as a symptomatic condition in which revision surgery was required. Results: The overall ASD rate was 9.0%, and the average ASD period was 4.7 years after primary surgery. With respect to clinical features of ASD, degenerative spondylolisthesis at the cranial fusion segment was the most frequent. In terms of repeat ASD, second and third ASD incidences were 1.1% and 0.4%, respectively. As for ASD by fusion length, age, and preoperative pathologies, ASD incidence was increased by fusion length, while the time period to ASD was significantly shorter in elderly patients and those with degenerative lumbar scoliosis. Conclusions: In the present study, the overall ASD incidence was 9.0%, and the average ASD period was 4.7 years after primary operation. Second and third ASD incidences were 1.1% and 0.4%, respectively. Fusion length affected the ASD incidence, while aging factor and preoperative pathology affected the ASD time period.

scholarly journals Placement of Unilateral Cortical Bone Trajectory Screws in Previously Instrumented Pedicle without Removal of Existing Hardware for Adjacent Segment Disease

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Rojeh Melikian ◽  
Sofia Yeremian
Keyword(s):  
United States ◽  
Case Report ◽  
Lumbar Spine ◽  
Posterior Instrumentation ◽  
Treatment Options ◽  
Pedicle Screws ◽  
The United States ◽  
Infection Risk ◽  
Adjacent Segment Disease ◽  
Adjacent Segment

Adjacent segment disease (ASD) in the lumbar spine is a possible consequence in segments adjacent to a fusion. As the number of lumbar fusions in the United States increases, the rates of ASD will continue to climb. There are several treatment options for ASD with open decompression and extension of the fusion being common. However, need for exposure and removal of existing instrumentation can lead to increased operative times resulting in increasing blood loss and infection risk. The purpose of this paper is to describe a case report for unilateral cortical trajectory screw instrumentation, allowing for posterior instrumentation without having to remove the existing pedicle screws in the setting of ASD. Our technique can be done with standard c-arm fluoroscopy without the need for navigation.

scholarly journals Adjacent segment disease in degenerative pathologies with posterior instrumentation

2015 ◽  
Vol 14 (1) ◽  
pp. 23-26 ◽  
Author(s):  
Ana Guadalupe Ramírez Olvera ◽  
Manuel Villarreal Arroyo ◽  
Luis Mario Hinojosa Martínez ◽  
Enrique Méndez Pérez ◽  
Luis Romeo Ramos Hinojosa
Keyword(s):  
Lumbar Spine ◽  
Posterior Instrumentation ◽  
Degenerative Spondylolisthesis ◽  
Case Series ◽  
Adjacent Segment Disease ◽  
Diagnosis And Treatment ◽  
Adjacent Segment ◽  
Degenerative Scoliosis ◽  
Radiographic Findings ◽  
Case Series Study

OBJECTIVE: To establish the real incidence of adjacent segment disease after fusion, and to identify the levels and predisposing factors for the pathology, as well as the functional results. METHODS: a retrospective case series study with level of evidence IIB, in a sample of 179 patients diagnosed with stenosis of the lumbar spine, spondylolisthesis and degenerative scoliosis, submitted to surgery in the period 2005 to December 2013, with posterior instrumentation and posterolateral fusion, with follow-up from 2007 until May 2014, in which the symptomology and radiographic findings were evaluated, to establish the diagnosis and treatment. RESULTS: the study included 179 patients diagnosed with stenosis of the lumbar spine (n=116), isthmic and degenerative spondylolisthesis (n=50) and degenerative scoliosis (n=13); during the study, 20 cases of adjacent level segment were identified, 80% of which were treated surgically with extension of the instrumentation, while 20% were treated conservatively with NSAIDs and therapeutic blocks. CONCLUSION: An incidence of 11% was found, with an average of 3.25 years in diagnosis and treatment, a prevalence of females and diagnosis of stenosis of the lumbar canal on posterior instrumentation, a predominance of levels L4-L5; 80% were treated with extension of the instrumentation. The complications were persistent radiculopathy, infection of the surgical wound, and one death due to causes not related to the lumbar pathology.

scholarly journals Proximal Fusion Level Above First Coronal Reverse Vertebrae: An Essential Factor Decreasing the Risk of Adjacent Segment Degeneration in Degenerative Lumbar Scoliosis

2021 ◽  
pp. 219256822199408
Author(s):  
Hui Wang ◽  
Zhuoran Sun ◽  
Longjie Wang ◽  
Da Zou ◽  
Weishi Li
Keyword(s):  
Mechanical Load ◽  
Stable Condition ◽  
Adjacent Segment Degeneration ◽  
Control Group ◽  
Adjacent Segment ◽  
Study Group ◽  
Degenerative Lumbar Scoliosis ◽  
Lumbar Scoliosis ◽  
Fusion Level ◽  
Scoliosis Progression

Study Design: Retrospective radiological analysis. Objective: To explore whether proximal fusion level above first coronal reverse vertebrae (FCRV) could decrease risk of adjacent segment degeneration (ASD) in degenerative lumbar scoliosis (DLS). Methods: One hundred and 16 DLS patients were divided into 2 groups according to occurrence of ASD: study group (ASD positive group) and control group (ASD negative group). FCRV was defined as the first vertebrae that presents opposite orientation of asymmetric Hounsfield unit (HU) ratio from the other vertebrae within major curve. Incidence of ASD was evaluated in subgroups according to location between FCRV and upper instrumented vertebrae (UIV). Results: The fusion level was shorter in study group than that in control group. There were 12 patients presented FCRV 2-level proximal than SV, 32 patients presented FCRV 1-level proximal than SV, 35 patients presented the same vertebra of FCRV with SV, 23 patients presented FCRV 1-level distal than SV, 14 patients presented FCRV 2-level distal than SV. When UIV located above FCRV, no patient presented ASD, while 15.4% patients presented ASD when UIV located on FCRV. In study group, proximal scoliosis progression was detected in 1 patient (3.9%) when UIV located on FCRV, and 17 patients (29.8%) when UIV located below FCRV. Conclusions: Proximal fusion level above FCRV could decrease the risk of ASD in DLS, especially for the proximal scoliosis progression. FCRV represent the transitional point of the mechanical load on coronal plane, and may be within a more stable condition than stable vertebrae measured from radiographs.

Risk Factors of Sagittal Decompensation After Long Posterior Instrumentation and Fusion for Degenerative Lumbar Scoliosis

Spine ◽  
2010 ◽  
Vol 35 (17) ◽  
pp. 1595-1601 ◽  
Author(s):  
Kyu-Jung Cho ◽  
Se-Il Suk ◽  
Seung-Rim Park ◽  
Jin Hyok Kim ◽  
Suk-Bong Kang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Posterior Instrumentation ◽  
Degenerative Lumbar Scoliosis ◽  
Lumbar Scoliosis

Adjacent Segment Disease: An Uncommon Complication after Cervical Expansile Laminoplasty: Case Report

Neurosurgery ◽  
2003 ◽  
Vol 53 (3) ◽  
pp. 770-773 ◽  
Author(s):  
Michael Y. Wang ◽  
Barth A. Green ◽  
Elizabeth Vitarbo ◽  
Allan D.O. Levi
Keyword(s):  
Clinical Presentation ◽  
Facet Joint ◽  
Posterior Instrumentation ◽  
Cord Compression ◽  
Adjacent Segment Disease ◽  
Adjacent Segment ◽  
Joint Motion ◽  
Disc Disease ◽  
Adjacent Level Degeneration ◽  
Uncommon Complication

Abstract OBJECTIVE AND IMPORTANCE Adjacent segment disc disease is a well-described phenomenon that occurs after anterior cervical spinal fusion. One of the advantages of cervical laminoplasty over anterior approaches is that although the treated segments are stiffened, no formal fusion is performed. This is thought to reduce the biomechanical stresses placed on adjacent levels and thus decrease the likelihood of adjacent level degeneration. CLINICAL PRESENTATION A 62-year-old man presented with myelopathy attributable to cervical spondylosis and underwent a C3–C7 laminoplasty. Improvements in gait were followed 2 years later by symptomatic disc degeneration and spinal cord compression at T1–T2, which rendered him wheelchair bound. INTERVENTION The patient was treated with a laminectomy at the level of stenosis accompanied by posterior instrumentation and fusion from C5 to T3. This resulted in clinical improvement, and the patient was returned to his baseline ambulatory status. CONCLUSION Adjacent segment disease is an uncommon complication that occurs after laminoplasty. Careful attention to preserving facet joint motion in the cervical spine may minimize the stresses placed on adjacent motion segments.

scholarly journals Posterior Instrumentation for Degenerative Lumbar Scoliosis in Elderly Patients

2012 ◽  
Vol 61 (3) ◽  
pp. 362-365
Author(s):  
Kohei Ishihara ◽  
Kenzo Shirasawa ◽  
Akihisa Yamashita ◽  
Tetsuya Watanabe
Keyword(s):  
Elderly Patients ◽  
Posterior Instrumentation ◽  
Degenerative Lumbar Scoliosis ◽  
Lumbar Scoliosis
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