EFFECTS ON ADJACENT SEGMENT AFTER MINIMUM FIVE-YEARS FOLLOWING INSTRUMENTED LUMBAR SPINAL FUSION IN INDIAN POPULATION

Mapping Intimacies ◽

10.36106/gjra/6811205 ◽

2020 ◽

pp. 132-135

Author(s):

Yogesh Kishorkant Pithwa

Keyword(s):

Spinal Fusion ◽

Lumbar Lordosis ◽

Indian Population ◽

Lower Limbs ◽

Walking Distance ◽

Adjacent Segment ◽

Lumbar Spinal Fusion ◽

Time Of Surgery ◽

Lumbar Spinal

Adjacent segment degeneration [ASD] after instrumented lumbar spinal fusion has been studied extensively in non-Indian population. Present study attempts to evaluate incidence of and factors predisposing to ASD in the Indian population. This was a retrospective study with the inclusion criteria being: patients who underwent lumbar spinal fusion for spondylolisthesis, trauma, infection or deformity with a minimum five-year follow-up. Exclusion criteria: postoperative iatrogenic surgical-site infections, revision surgeries, postoperative implant failure and pseudarthrosis. Radiographs reviewed immediate postoperatively, and at final follow-up. Global lumbar lordosis from L1-S1; and angulation and translation of spinal motion segment immediately adjacent [cranial and caudal] to fused segment were studied. ASD was defined using White and Panjabi’s criteria. At final follow-up, VAS for lower back as well as lower limbs was noted separately along with walking distance. Twenty patients [49.4+17.4years] included [six males, fourteen females]. ASD was seen in 13 of 20 [65%] patients. Age>50years at the time of surgery and global lumbar lordosis <40° in the immediate postoperative period were identified as significant risk factors for ASD [p=0.02 and 0.03, respectively]. However, no significant correlation was noted between development of ASD and extension of fusion to sacrum. Nor was there any correlation between ASD and gender or length of fusion. It was also notable that no significant differences were identified in VAS scores and walking distance between patients with and without ASD. To conclude, among the various factors studied, age>50years at the time of surgery and immediate postoperative global lumbar lordosis <400 were significantly associated with development of ASD after a minimum follow-up of five years.

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Pelvic incidence-lumbar lordosis mismatch predisposes to adjacent segment disease after lumbar spinal fusion

European Spine Journal ◽

10.1007/s00586-014-3454-0 ◽

2014 ◽

Vol 24 (6) ◽

pp. 1251-1258 ◽

Cited By ~ 95

Author(s):

Dominique A. Rothenfluh ◽

Daniel A. Mueller ◽

Esin Rothenfluh ◽

Kan Min

Keyword(s):

Spinal Fusion ◽

Lumbar Lordosis ◽

Pelvic Incidence ◽

Adjacent Segment Disease ◽

Adjacent Segment ◽

Lumbar Spinal Fusion ◽

Lumbar Spinal

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Postoperative bisphosphonate do not significantly alter the fusion rate after lumbar spinal fusion: a meta-analysis

Journal of Orthopaedic Surgery and Research ◽

10.1186/s13018-021-02444-z ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Jun Mei ◽

Xiaoxu Song ◽

Xiaoming Guan ◽

Dou Wu ◽

Junjie Wang ◽

...

Keyword(s):

Bone Formation ◽

Spinal Fusion ◽

Meta Analysis ◽

Fusion Rate ◽

Lumbar Spinal Fusion ◽

Fusion Surgery ◽

Number Of Patients ◽

Cage Subsidence ◽

Lumbar Spinal

Abstract Background To evaluate the effect of postoperative BP treatment on improving the fusion rate after lumbar spinal fusion surgery by performing a meta-analysis of randomized controlled trials (RCTs) and other comparative cohort studies. Methods A comprehensive search of PubMed, EMBASE, the Web of Science, and the Cochrane Central Register of Controlled Trials was performed for RCTs and other comparative cohort studies on the effect of BP treatment on improving the fusion rate after lumbar spinal fusion surgery. The primary outcome measures were the number of patients with bone formation grades A, B, and C at 12 months of follow-up; fusion rates at 12 and 24 months of follow-up; vertebral compression fracture (VCF) at 12 and 24 months of follow-up; pedicle screw loosening at 24 months of follow-up; and cage subsidence, the Oswestry disability index (ODI), and the visual analogue score (VAS) at 12 months of follow-up. The final search was performed in July 2020. Results Seven studies with 401 patients were included. Compared with the placebo, BP treatment did not significantly alter the number of patients with bone formation grades A, B, and C, or the VAS at the 12-month follow-up or the fusion rates at the 12- and 24-month follow-ups. In addition, compared with the placebo, BPs significantly reduced the risks of VCF at the 12- and 24-month follow-ups, pedicle screw loosening at the 24-month follow-up, and cage subsidence and the ODI at the 12-month follow-up. Conclusions Postoperative BPs do not clearly improve bone formation and the fusion rate, but they reduce VCF, cage subsidence, and loosening of pedicle screws after lumbar fusion surgery compared with the control treatment.

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Effectiveness of Reoperations for Adjacent Segment Disease Following Lumbar Spinal Fusion

Orthopedics ◽

10.3928/01477447-20170621-02 ◽

2017 ◽

Vol 41 (2) ◽

pp. e161-e167 ◽

Cited By ~ 3

Author(s):

Austin Drysch ◽

Remi M. Ajiboye ◽

Akshay Sharma ◽

Jesse Li ◽

Tara Reza ◽

...

Keyword(s):

Spinal Fusion ◽

Adjacent Segment Disease ◽

Adjacent Segment ◽

Lumbar Spinal Fusion ◽

Lumbar Spinal

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Correlation Between Clinical Result and Adjacent Segment Degeneration After Lumbar Spinal Fusion

Journal of Korean Society of Spine Surgery ◽

10.4184/jkss.2008.15.1.38 ◽

2008 ◽

Vol 15 (1) ◽

pp. 38 ◽

Cited By ~ 1

Author(s):

Jun-Young Yang ◽

June-Kyu Lee ◽

Ho-Sup Song ◽

Tae-Hoon Kim ◽

Kyu-Woong Yeon

Keyword(s):

Spinal Fusion ◽

Clinical Result ◽

Adjacent Segment Degeneration ◽

Adjacent Segment ◽

Lumbar Spinal Fusion ◽

Lumbar Spinal

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The Impact of Complications on Total Health Care Spending and Resource Utilization during a 2–3 Vertebra Lumbar Spinal Fusion and the 90-Day Follow-Up Period among Medicare Beneficiaries

The Spine Journal ◽

10.1016/j.spinee.2017.08.042 ◽

2017 ◽

Vol 17 (10) ◽

pp. S194

Author(s):

Michael J. Schlosser ◽

Kenneth M. Little ◽

Kevin G. Shea ◽

Ed Hickey ◽

April W. Simon

Keyword(s):

Health Care ◽

Spinal Fusion ◽

Resource Utilization ◽

Health Care Spending ◽

Medicare Beneficiaries ◽

Lumbar Spinal Fusion ◽

Lumbar Spinal ◽

The Impact

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MIS Fusion of the SI Joint: Does Prior Lumbar Spinal Fusion Affect Patient Outcomes?

The Open Orthopaedics Journal ◽

10.2174/1874325001307010163 ◽

2013 ◽

Vol 7 (1) ◽

pp. 163-168 ◽

Cited By ~ 21

Author(s):

Leonard Rudolf

Keyword(s):

Lumbar Spine ◽

Spinal Fusion ◽

Spine Fusion ◽

Lumbar Spinal Fusion ◽

Lumbar Spine Fusion ◽

Spine Pathology ◽

History Of ◽

Lumbar Spinal ◽

Si Joint

Background: Sacroiliac (SI) joint pain is a challenging condition to manage as it can mimic discogenic or radicular low back pain, and present as low back, hip, groin and/or buttock pain. Patients may present with a combination of lumbar spine and SI joint symptoms, further complicating the diagnosis and treatment algorithm [1-3]. SI joint pain after lumbar spinal fusion has been reported in the literature. Both clinical and biomechanical studies show the SI joint to be susceptible to increased motion and stress at the articular surface with up to 40-75% of patients developing significant SI joint degeneration after 5 years. In a recent case series study of 50 patients who underwent minimally invasive SI joint arthrodesis, 50% had undergone previous lumbar spinal fusion and 18% had symptomatic lumbar spine pathology treated conservatively [4]. The purpose of this study is to determine if history of previous lumbar fusion or lumbar pathology affects patient outcomes after MIS SI joint fusion surgery. Methods: We report on 40 patients with 24 month follow up treated with MIS SI joint fusion using a series of triangular porous plasma coated titanium implants (iFuse, SI-Bone, Inc. San Jose, CA). Outcomes using a numerical rating scale (NRS) for pain were obtained at 3-, 6-, 12- and 24 month follow up intervals. Additionally, patient satisfaction was collected at the latest follow up interval. Patients were separated into 3 cohorts: 1) underwent prior lumbar spine fusion (PF), 2) no history of previous lumbar spine fusion (NF), 3) no history of previous lumbar spine fusion with symptomatic lumbar spine pathology treated conservatively (LP). A repeated measures analysis of variance (rANOVA) was used to determine if the change in NRS pain scores differed across timepoints and subgroups. A decrease in NRS by 2 points was deemed clinically significant [5]. Results: Mean age was 54 (±13) years and varied slightly but not statistically between groups. All subgroups experienced a clinically and statistically significant reduction in pain at all time points (mean change >2 points, p<0.001). There was a statistically significant effect of cohort (p=0.045), with the NF cohort (no prior lumbar spinal fusion) having a somewhat greater decrease in pain (by approximately 1 point) compared to the other 2 groups (PF and LP).Patient reported satisfaction by cohort was: 89% (NF), 92% (PF) and 63% (LP).Overall satisfaction rate was 87%. Discussion and Conclusion: Patients with SI joint pain, regardless of prior lumbar spine fusion history, show significant improvement in pain after minimally invasive SI joint fusion. The presence of symptomatic lumbar spine pathology potentially confounds the treatment affect, as patients may not be able to discriminate between symptoms arising from the SI joint and the lumbar spine. These patients expressed a lower satisfaction with surgery. Patients without other confounding lumbar spine pathology and who have not undergone previous spine surgery tend to be younger and experience a greater reduction in pain.

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