Estimating the risk for symptomatic adjacent segment degeneration after lumbar fusion: analysis from a cohort of patients undergoing revision surgery
Alberto Di Martino, Carlo Cosimo Quattrocchi, Laura Scarciolla, Nicola Papapietro, Bruno Beomonte Zobel, Vincenzo Denaro
October 2014, Volume 23, Issue 6, pp 693 - 698 Original Article Read Full Article 10.1007/s00586-014-3551-0
First Online: 12 September 2014
Purpose
Aim of this study is to estimate the risk for symptomatic adjacent segment degeneration (ASD) and examine the association between spino-pelvic parameters and ASD.
Methods
22 patients operated upon by instrumented lumbar or lumbosacral spinal fusion and re-operated upon for ASD were enrolled in the study. 83 consecutive patients with the same surgery and never re-operated upon were the controls. Pelvic incidence, sacral slope (SS), pelvic tilt (PT), and lumbar lordosis were calculated.
Results
Patients with ASD had significantly lower SS (p = 0.005) and higher PT values (p 21°, were at higher risk for symptomatic ASD (relative risk 1.73 for SS and 3.663 for PT).
Conclusions
In patients re-operated upon for ASD, pelvic retroversion and hyperlordosis are the main mechanisms of compensation for the unbalanced spine. Patients with PT above 21° and SS below 39° are at higher risk for symptomatic ASD.
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