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Risk factors of radiological adjacent disc degeneration with lumbar interbody fusion for degenerative spondylolisthesis.
- Source :
-
Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association [J Orthop Sci] 2016 Mar; Vol. 21 (2), pp. 133-7. Date of Electronic Publication: 2015 Dec 22. - Publication Year :
- 2016
-
Abstract
- Background: Although various risk factors have been reported for adjacent segment degeneration after lumbar fusion, the exact mechanisms and risk factors related to adjacent segment degeneration have not been clear. The present study was conducted to evaluate the risk factors for radiological adjacent segment degeneration in patients surgically treated for single-level L4 spondylolisthesis focusing on a single pathology, a specific fusion level, at a set interval.<br />Methods: We assessed preoperative and five-year postoperative radiographs for 72 patients who underwent L4-5 anterior or posterior lumbar interbody fusion for single-level L4 degenerative spondylolisthesis. Adjacent segment degeneration was defined as imaging evidence of one or more of the following conditions at L1-2, L2-3, or L3-4: 1) a loss of more than 20% of the preoperative disc height, 2) anterolisthesis or retrolisthesis greater than 3 mm, 3) or osteophyte formation greater than 3 mm.<br />Results: We found adjacent segment degeneration in 21 patients, with 31 discs affected. Multiple logistic regression analysis identified the following significant independent risk factors for adjacent segment degeneration: female gender (odds ratio 10.80; 95% confidence interval 1.20-96.89), posterior lumbar interbody fusion (odds ratio 7.70; 95% confidence interval 1.82-32.66), and pre-existing disc degeneration (odds ratio 12.29; 95% confidence interval 1.69-89.27).<br />Conclusions: Female gender, posterior lumbar interbody fusion, and pre-existing disc degeneration were significant independent risk factors for radiologically diagnosed adjacent segment degeneration in patients treated for L4 degenerative spondylolisthesis by interbody lumbar fusion.<br /> (Copyright © 2015 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved.)
- Subjects :
- Female
Humans
Incidence
Intervertebral Disc Degeneration etiology
Japan epidemiology
Male
Middle Aged
Postoperative Complications epidemiology
Risk Factors
Spondylolisthesis diagnosis
Intervertebral Disc Degeneration diagnosis
Lumbar Vertebrae diagnostic imaging
Postoperative Complications diagnosis
Radiography methods
Risk Assessment methods
Spinal Fusion adverse effects
Spondylolisthesis surgery
Subjects
Details
- Language :
- English
- ISSN :
- 1436-2023
- Volume :
- 21
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association
- Publication Type :
- Academic Journal
- Accession number :
- 26727309
- Full Text :
- https://doi.org/10.1016/j.jos.2015.12.007