Paraspinal muscle, facet joint, and disc problems: risk factors for adjacent segment degeneration after lumbar fusion

Kim, Jong Yeol; Ryu, Dal Sung; Paik, Hyo Chae; Ahn, Sang Soak; Kang, Moo Sung; Kim, Kyung Hyun; Park, Jeong Yoon; Chin, Dong Kyu; Kh, Kim; Cho, Young-Eun; Kuh, Sung Uk

doi:10.1016/j.spinee.2016.03.010

Cited by 118 publications

(114 citation statements)

References 56 publications

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“…[13][14][15][16][17][18][19][20][21] However, some studies have reported no correlation between ASD incidence and age. [9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27] In our study, there was no relationship between advancing age and ASD.…”

Section: Discussioncontrasting

confidence: 61%

Adjacent segment disease after posterior lumbar instrumentation surgery for degenerative disease: Incidence and risk factors

Bagheri

Alimohammadi

Froushani

et al. 2019

J Orthop Surg (Hong Kong)

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To identify risk factors for occurrence of symptomatic adjacent segment disease (ASD) after posterior lumbar instrumentation surgery. Methods: This retrospective study evaluated 630 patients who underwent posterior lumbar transpedicular instrumentation for degenerative lumbar disorders between April 2008 and April 2012. On the basis of developing ASD at follow-up, patients were categorized into two groups: the ASD group and the non-ASD (N-ASD) group. These two groups were compared for patient characteristics, surgical variables, and radiographic parameters to investigate the possible predictive factors of ASD. Results: Of the 630 individuals participated in the study, 76 (12.1%) patients had ASD. Mean and standard deviation of age were 61.37 + 4.12 years for the ASD group and 62.37 + 3.9 for the N-ASD group (p ¼ 0.79). The average follow-up period was 51 + 2.2 months in the ASD group and 52 + 2.3 months in the N-ASD group (p ¼ 0.691). There were no significant differences between the two groups in terms of gender, diabetes mellitus (DM), hypertension, smoking, and osteoporosis, with all p > 0.05. The logistic regression analysis demonstrated that higher preoperative body mass index (BMI; odds ratio (OR) 1.233, p ¼ 0.005), preoperative disc degeneration (OR 1.033, p ¼ 0.024), decreased postoperative lumbar lordosis (OR 3.080, p ¼ 0.011), fusion at more than four levels (OR 4.280, p ¼ 0.014), and intraoperative superior facet joint violation (OR 7.480, p ¼ 0.009) were independently associated with ASD. Conclusions: Patients with higher preoperative BMI, preoperative disc degeneration, decreased postoperative lumbar lordosis, fusion at more than four levels, and intraoperative superior facet joint violation have a statistically significant increased risk of developing ASD.

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Section: Discussioncontrasting

confidence: 61%

Adjacent segment disease after posterior lumbar instrumentation surgery for degenerative disease: Incidence and risk factors

Bagheri

Alimohammadi

Froushani

et al. 2019

J Orthop Surg (Hong Kong)

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“…Therefore, a high BMI will increase the load on instruments and even lead to the deformation of implants. The fractured vertebra has healed before implant removal; therefore, the KR after implant removal may be mainly caused be the loss of UIVA correction; in this period, a higher BMI with longer action time is needed to result in space collapse, reduction of buffering capacity and degeneration of upper intervertebral discs [21]. Chung et al [22] reported that diabetes mellitus could increase the risk of fragility fractures, which was often associated with osteoporosis.…”

Section: Discussionmentioning

confidence: 99%

Risk factor analysis for predicting kyphosis reoccurrence of thoracolumbar burst fracture patients treated with posterior short-segment fixation

Sun

Chen

Sun³

et al. 2020

Preprint

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Background: The thresholds of risk factors of kyphosis recurrence in thoracolumbar burst fracture patients were still controversial. The aim of this multi-center study was to identify these thresholds. Methods: 169 patients were included in this study. Upper intervertebral angle (UIVA), lower intervertebral angle (LIVA), Cobb angle (CA), anterior vertebral height ratio (AVH%), regional angle (RA), posterior vertebral height ratio (PVH%), vertebral wedge angle (VWA), anteroposterior ratio (A/P%), Clinical assessment included Load Sharing Classification (LSC) score, Thoracolumbar Injury Classification and Severity (TLICS) score, Visual Analogue Scale (VAS), and Body mass index (BMI) were perioperatively evaluated. Patients were divided into KR group and none KR (NKR) group according to whether the loss of CA correction was less than 5˚ or not. The risk factors of KR before or after implant removal were analyzed, respectively. Results: There were significant improvements in postoperative parameters compared with preoperative parameters, such as AVH%, A/P%, VAS, CA, VWA, PVH% ( P < 0.001, respectively), and UIVA ( P = 0.02). Age (AUC = 0.828) and BMI (AUC = 0.846) were good predictors of KR before implant removal. BMI (AUC = 0.871) was a good predictor of KR after implant removal. Conclusions: There were significant differences in risk factors of KR at different postoperative follow-up stages: age > 49 years, BMI > 24 were risk factors of KR before implant removal; BMI > 25.17 was a risk factor of KR after implant removal.

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“…Therefore, a high BMI will increase the load on instruments and even lead to the deformation of implants. The fractured vertebra has healed after implant removal; therefore, the KR after implant removal may be mainly caused be the loss of UIVA correction; in this period, a higher BMI with longer action time is needed to result in space collapse, reduction of buffering capacity and degeneration of upper intervertebral discs [20]. Chung et al [21] reported that diabetes mellitus could increase the risk of fragility fractures, which was often associated with osteoporosis.…”

Section: Discussionmentioning

confidence: 99%

Risk factor analysis for predicting kyphosis reoccurrence of thoracolumbar burst fracture patients treated with posterior short-segment fixation

Zhang

Sun

et al. 2019

Preprint

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KEYWORDSRisk factors; kyphosis reoccurrence; posterior short-segment fixation; thoracolumbar burst fracture. AbstractBackground: The thresholds of risk factors of kyphosis recurrence in thoracolumbar burst fracture patients were still controversial. The aim of this multi-center study was to identify these thresholds. Methods: 169 patients were included in this study. Upper intervertebral angle (UIVA), lower intervertebral angle (LIVA), Cobb angle (CA), anterior vertebral height ratio (AVH%), regional angle (RA), posterior vertebral height ratio (PVH%), vertebral wedge angle (VWA), anteroposterior ratio (A/P%), Clinical assessment included Load Sharing Classification (LSC) score, Thoracolumbar Injury Classification and Severity (TLICS) score, Visual Analogue Scale (VAS), and Body mass index (BMI) were perioperatively evaluated. Patients were divided into KR group and none KR (NKR) group according to whether the loss of CA correction was less than 5˚ or not. The risk factors of KR before or after implant removal were analyzed, respectively. Results: There were significant improvements in postoperative parameters compared with preoperative parameters, such as AVH%, A/P%, VAS, CA, VWA, PVH% (P < 0.001, respectively), and UIVA (P = 0.02). Age (AUC = 0.828) and BMI (AUC = 0.846) were good predictors of KR before implant removal. BMI (AUC = 0.871) was a good predictor of KR after implant removal. Conclusions: There were significant differences in risk factors of KR at different postoperative follow-up stages: age > 49 years, BMI > 24 were risk factors of KR before implant removal; BMI > 25.17 was a risk factor of KR after implant removal.

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Paraspinal muscle, facet joint, and disc problems: risk factors for adjacent segment degeneration after lumbar fusion

Cited by 118 publications

References 56 publications

Adjacent segment disease after posterior lumbar instrumentation surgery for degenerative disease: Incidence and risk factors

Adjacent segment disease after posterior lumbar instrumentation surgery for degenerative disease: Incidence and risk factors

Risk factor analysis for predicting kyphosis reoccurrence of thoracolumbar burst fracture patients treated with posterior short-segment fixation

Risk factor analysis for predicting kyphosis reoccurrence of thoracolumbar burst fracture patients treated with posterior short-segment fixation

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