scholarly journals Risk Factors for Spine Reoperation and Joint Replacement Surgeries after Short-Segment Lumbar Spinal Surgeries for Lumbar Degenerative Disc Disease: A Population-Based Cohort Study

2021 ◽  
Vol 10 (21) ◽  
pp. 5138
Author(s):  
Meng-Huang Wu ◽  
Christopher Wu ◽  
Jiann-Her Lin ◽  
Li-Ying Chen ◽  
Ching-Yu Lee ◽  
...  
Keyword(s):  
Risk Factors ◽  
Joint Replacement ◽  
Degenerative Disc Disease ◽  
Population Based ◽  
Disc Disease ◽  
Short Segment ◽  
Fusion Surgery ◽  
Degenerative Disc ◽  
Lumbar Spinal Surgery ◽  
Lumbar Spinal

Background: Short-segment lumbar spinal surgery is the most performed procedure for treatment of degenerative disc disease. However, population-based data regarding reoperation and joint replacement surgeries after short-segment lumbar spinal surgery is limited. Methods: The study was a retrospective cohort design using the Taiwan National Health Insurance Research Database for data collection. Patients selected were diagnosed with lumbar degenerative disc disease and undergone lumbar discectomy surgery between 2002 and 2013. The Kaplan–Meier method was used to estimate the incidence of 1-year spine reoperation and joint replacement surgeries, and the Cox proportional hazard regression was used to examine risk factors associated with the outcomes of interest. Results: A total of 90,105 patients were included. Incidences of 1-year spine reoperation and joint replacement surgeries for the hip and knee were 0.27, 0.04, and 0.04 per 100 people/month. Compared to fusion with the fixation group, fusion without fixation and the non-fusion group had higher risks of spine reoperation. Risk factors associated with spine reoperation included fusion without fixation, non-fusion surgery, age ≥ 45 years old, male gender, diabetes, a Charlson Comorbidity Index = 0, lowest social economic status, and steroid use history. Spine surgeries were not risk factors for joint replacement surgeries. Conclusions: Non-fusion surgery and spinal fusion without fixation had higher risks for spine reoperation. Spine surgeries did not increase the risk for joint replacement surgeries.

Lumbar Fusion Surgery for Patients With Back Pain and Degenerative Disc Disease: An Observational Study From the Canadian Spine Outcomes and Research Network

2021 ◽  
pp. 219256822098547
Author(s):  
Nathan Evaniew ◽  
Ganesh Swamy ◽  
W. Bradley Jacobs ◽  
Jacques Bouchard ◽  
Roger Cho ◽  
...  
Keyword(s):  
Back Pain ◽  
Degenerative Disc Disease ◽  
Short Form ◽  
Lumbar Fusion ◽  
Research Network ◽  
Disc Disease ◽  
Fusion Surgery ◽  
Degenerative Disc ◽  
Lumbar Fusion Surgery ◽  
Related Quality

Study Design: Uncontrolled retrospective observational study. Objectives: Surgery for patients with back pain and degenerative disc disease is controversial, and studies to date have yielded conflicting results. We evaluated the effects of lumbar fusion surgery for patients with this indication in the Canadian Spine Outcomes and Research Network (CSORN). Methods: We analyzed data that were prospectively collected from consecutive patients at 11 centers between 2015 and 2019. Our primary outcome was change in patient-reported back pain at 12 months of follow-up, and our secondary outcomes were satisfaction, disability, health-related quality of life, and rates of adverse events. Results: Among 84 patients, we observed a statistically significant improvement of back pain at 12 months that exceeded the threshold of Minimum Clinically Important Difference (MCID) (mean change -3.7 points, SD 2.6, p < 0.001, MCID = 1.2; 77% achieved MCID), and 81% reported being “somewhat” or “extremely” satisfied. We also observed improvements of Oswestry Disability Index (-17.3, SD 16.6), Short Form-12 Physical Component Summary (10.3, SD 9.6) and Short Form-12 Mental Component Summary (3.1, SD 8.3); all p < 0.001). The overall rate of adverse events was 19%. Conclusions: Among a highly selective group of patients undergoing lumbar fusion surgery for degenerative disc disease, most experienced a clinically significant improvement of back pain as well as significant improvements of disability and health-related quality of life, with high satisfaction at 1 year of follow-up. These findings suggest that surgery for this indication may provide some benefit, and that further research is warranted.

Sagittal alignment assessment after short-segment lumbar fusion for degenerative disc disease

2018 ◽  
Vol 43 (4) ◽  
pp. 891-898 ◽  
Author(s):  
Farzam Vazifehdan ◽  
Vasilios G. Karantzoulis ◽  
Vasilios G. Igoumenou
Keyword(s):  
Degenerative Disc Disease ◽  
Sagittal Alignment ◽  
Lumbar Fusion ◽  
Disc Disease ◽  
Short Segment ◽  
Degenerative Disc

scholarly journals Artificial disc replacement versus fusion in patients with cervical degenerative disc disease with radiculopathy: 5-year outcomes from the National Swedish Spine Register

2019 ◽  
Vol 30 (2) ◽  
pp. 159-167 ◽  
Author(s):  
Anna MacDowall ◽  
Martin Skeppholm ◽  
Lars Lindhagen ◽  
Yohan Robinson ◽  
Håkan Löfgren ◽  
...  
Keyword(s):  
Propensity Score ◽  
Propensity Score Matching ◽  
Degenerative Disc Disease ◽  
Artificial Disc ◽  
Anterior Decompression ◽  
Disc Disease ◽  
Fusion Surgery ◽  
Degenerative Disc ◽  
Clinically Important Difference ◽  
Cervical Degenerative Disc Disease

OBJECTIVEThe long-term efficacy of artificial disc replacement (ADR) surgery compared with fusion after decompression for the treatment of cervical degenerative disc disease and radiculopathy has not previously been investigated in a population-based setting.METHODSAll patients with cervical degenerative disc disease and radiculopathy who were in the national Swedish Spine Registry (Swespine) beginning in January 1, 2006, were eligible for the study. Follow-up information was obtained up to November 15, 2017. The authors compared, using propensity score matching, patients treated with anterior decompression and insertion of an ADR with patients who underwent anterior decompression combined with fusion surgery. The primary outcome was the Neck Disability Index (NDI), a patient-reported function score ranging from 0% to 100%, with higher scores indicating greater disability and a minimum clinically important difference of > 15%.RESULTSA total of 3998 patients (2018:1980 women/men) met the inclusion criteria, of whom 204 had undergone arthroplasty and 3794 had undergone fusion. After propensity score matching, 185 patients with a mean age of 49.7 years remained in each group. Scores on the NDI were approximately halved in both groups after 5 years, but without a significant mean difference in NDI (3.0%; 95% CI −8.4 to 2.4; p = 0.28) between the groups. There were no differences between the groups in EuroQol–5 Dimensions or in pain scores for the neck and arm.CONCLUSIONSIn patients with cervical degenerative disc disease and radiculopathy, decompression plus ADR surgery did not result in a clinically important difference in outcomes after 5 years, compared with decompression and fusion surgery.

scholarly journals Evidence that bone mineral density plays a role in degenerative disc disease: the UK Twin Spine Study

2010 ◽  
Vol 69 (12) ◽  
pp. 2102-2106 ◽  
Author(s):  
Gregory Livshits ◽  
Sergey Ermakov ◽  
Maria Popham ◽  
Alex J MacGregor ◽  
Philip N Sambrook ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Lumbar Spine ◽  
Bone Mineral ◽  
Degenerative Disc Disease ◽  
Large Population ◽  
Population Sample ◽  
Population Based ◽  
Mineral Density ◽  
Disc Disease ◽  
Degenerative Disc

ObjectiveOsteoarthritis (OA) and osteoporosis are often considered to lie at opposite ends of a spectrum of bone phenotypes. Lumbar degenerative disc disease (LDD) may be associated with low back pain (LBP) and is similar in many ways to OA. LDD is reported in small studies to be associated with increased spine bone mineral density (BMD). The present work aimed to confirm this association in a large population sample using MRI and explore the relationship further, in particular to determine whether it is mediated genetically.MethodsA population based sample (N=908, age range 32–74 years) of UK female twins having MRI of the lumbar spine was used in this study. LDD traits and summary measures and their relationship with BMD at the lumbar spine and hip were examined using multivariate multiple regression and maximum likelihood based variance decomposition.ResultsThere was a significant positive correlation between LDD and BMD at the lumbar spine and hip, which remained significant after adjustment for confounders. Both traits were highly heritable and the associations between them were mediated genetically.ConclusionsA clear, significant and independent association of BMD at hip and lumbar spine with LDD was found which is, in part, genetically mediated. The association with the non-axial site, the hip, is of particular interest and suggests a systemic bone effect. This should encourage the search for pleiotropic genes to help in the understanding of the bone–cartilage relationship. Moreover, genetic variants identified could provide novel therapeutic targets in the management of LBP.

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