Incidence and Risk Factors for Adjacent Segment Disease After Transforaminal Lumbar Interbody Fusion in Patients with Lumbar Degenerative Diseases

Ye, Jiawen; Yang, Sizhen; Wei, Zihan; Cai, Chenhui; Zhang, Ying; Qiu, Hao; Chu, Tongwei

doi:10.2147/ijgm.s337298

Cited by 17 publications

(19 citation statements)

References 21 publications

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“…Third, the lack of a corresponding biomechanical study makes it difficult to evaluate the long-term biomechanical properties of the pedicle screw in the cranial direction. Fourth, the approximately 1 year of follow-up in this study is shorter than that of some previous studies, meaning that some complications, like reoperation rate, adjacent segment degeneration, and pedicle screw break, which are typically reported after 2 years of follow-up, might not have been encountered (5,49,50). Fifth, the requirement of complete clinical and radiographic data in the inclusion criteria might have introduced some selection bias.…”

Section: Discussionmentioning

confidence: 89%

Correlation between direction of pedicle screw and restoration of lumbar degenerative scoliosis in degenerative lumbar spondylolisthesis: a retrospective study

Zhan¹,

Zhan²,

Yu³

et al. 2023

Quant Imaging Med Surg

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Background: Inferior clinical outcomes have been reported in patients with degenerative lumbar spondylolisthesis (DLS) accompanied by lumbar degenerative scoliosis, but little attention has been paid to its radiologic assessment or preoperative planning. The aim of this study was to analyze the effect of transforaminal lumbar interbody fusion on patients with DLS and lumbar degenerative scoliosis and explore the surgical aspects benefiting the restoration of lumbar degenerative scoliosis.Methods: All patients with DLS and lumbar degenerative scoliosis undergoing single-level unilateral transforaminal lumbar interbody fusion surgery between July 1, 2015, and April 30, 2021, were screened in this retrospective cohort study. Clinical outcomes including visual analog scale (VAS), Oswestry disability index (ODI), and radiographic parameters of sagittal and coronal alignment, cage spatial locations, and angle of pedicle screw (parallel, cranial, and caudad angle) were assessed. Coronal asymmetry was demonstrated by the intervertebral height difference between the medial and lateral margins of indexed intersegmental space.The correlations between Δintervertebral height difference (postoperative intervertebral height differencepreoperative intervertebral height difference) and radiographic parameters and clinical outcomes were analyzed by univariable, multivariable, mediation, and correlation analyses. Significance was set at a bilateral P<0.05.Results: A total of 57 included patients were followed up for a minimum of 1 year. Reduction of VAS, ODI, and improvement of radiographic parameters were found after surgery. The cranial angle of the lower pedicle screw positively correlated with Δintervertebral height difference restoration (b=0.54; standard error=0.11; P<0.001).Conclusions: Transforaminal lumbar interbody fusion surgery appears to be an effective approach to improving the radiographic and clinical outcomes of patients with DLS and lumbar degenerative scoliosis.The cranial direction of the lower pedicle screws in single-level unilateral transforaminal lumbar interbody fusion surgery may be associated with a better postoperative restoration of lumbar degenerative scoliosis.

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Section: Discussionmentioning

confidence: 89%

Correlation between direction of pedicle screw and restoration of lumbar degenerative scoliosis in degenerative lumbar spondylolisthesis: a retrospective study

Zhan¹,

Zhan²,

Yu³

et al. 2023

Quant Imaging Med Surg

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show abstract

“… 54 Incidence has a wide range between 2,62 and 84% with a prevalence of proximal level and main associated factors were old age, body mass index (BMI), previous degenerative disc o facet disease, type of pathology, multiple-level fusion, male, intraoperative superior facet joint violation, laminectomy, sagittally oriented facet joint angle, PLIF and progressive fatty degeneration of the multifidus muscle. 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65…”

Section: Discussionmentioning

confidence: 99%

Relationship between lumbar lordosis, pelvic parameters, PI-LL mismatch and outcome after short fusion surgery for lumbar degenerative disease. Literature review, rational and presentation of public study protocol: RELApSE study (registry for evaluation of lumbar arthrodesis sagittal alignEment)

Tartara

Garbossa

Armocida

et al. 2023

World Neurosurgery: X

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“…[3][4][5] As a common complication of lumbar fusion surgery, the incidence of ASD is increasing with more patients undergoing lumbar interbody fusion, and its main pathological manifestations are herniated discs, narrowed disc height, lumbar spondylolisthesis, spinal canal stenosis, and facet joint osteoarthritis. [6][7][8] In addition to risk factors such as age, body mass index, smoking, osteoporosis, and a pre-existing disc of adjacent segments, increased intradiscal stress of adjacent segments after spinal fusion and segmental instability distracted from the stiffness of the fusion segment also have a close impact on ASD progression. 2,[9][10][11][12] The traditional procedure of posterior lumbar interbody fusion (PLIF) requires extensive stripping of the paraspinal muscles during exposure, while for adequate spinal canal decompression, the posterior column structures, such as the spinous process and posterior ligament complex (PLC), need to be removed and then discectomy and intervertebral fusion are performed.…”

Section: Introductionmentioning

confidence: 99%

Biomechanical effects of iatrogenic muscle-ligaments complex damage on adjacent segments following posterior lumbar interbody fusion: A finite element analysis

Wei,

Wang,

et al. 2023

Int J Artif Organs

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Objective: To analyze the biomechanical effects of proximal iatrogenic muscle-ligaments complex (MLC) damage on adjacent segments following posterior lumbar interbody fusion (PLIF) by finite element (FE) analysis. Methods: The multifidus muscle force was loaded in the validated intact lumbosacral finite element model. Based on whether undergoing PLIF or the proximal MLC damage, three models were established. Range of motion (ROM) and the maximum von Mises (VM) stress of adjacent segments were analyzed, as well as the average muscle force and work capacity in four loading directions. Results: PLIF results in significant changes in ROM and stress. ROM changed significantly in the upper adjacent segment, the PLIF model changed the most in extension, and the largest change in the lower adjacent segment occurred after MLC damage. The VM stress of the upper adjacent segment occurred in extension of the PLIF model, and that of the lower adjacent segment occurred in rotation after MLC damage. In flexion, ROM, and stress of the damaged MLC fusion model were significantly increased compared with the normal and PLIF models, there was a stepwise amplification. The average muscle force comparison of three models was 5.8530, 12.3185, and 13.4670 N, respectively. The total work capacity comparison was close to that of muscle force. Conclusion: PLIF results in increased ROM and the VM stress of adjacent segments, the proximal MLC damage will aggravate this change. This may increase the risk of ASD and chronic low back pain. Preserving the proximal MLC reduces the biomechanical effects on adjacent segments.

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Incidence and Risk Factors for Adjacent Segment Disease After Transforaminal Lumbar Interbody Fusion in Patients with Lumbar Degenerative Diseases

Cited by 17 publications

References 21 publications

Correlation between direction of pedicle screw and restoration of lumbar degenerative scoliosis in degenerative lumbar spondylolisthesis: a retrospective study

Correlation between direction of pedicle screw and restoration of lumbar degenerative scoliosis in degenerative lumbar spondylolisthesis: a retrospective study

Relationship between lumbar lordosis, pelvic parameters, PI-LL mismatch and outcome after short fusion surgery for lumbar degenerative disease. Literature review, rational and presentation of public study protocol: RELApSE study (registry for evaluation of lumbar arthrodesis sagittal alignEment)

Biomechanical effects of iatrogenic muscle-ligaments complex damage on adjacent segments following posterior lumbar interbody fusion: A finite element analysis

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