Radiologic adjacent segment degeneration 2 years after lumbar fusion for degenerative spondylolisthesis

Moreau, Pierre Emmanuel; Ferrero, Emmanuelle; Riouallon, Guillaume; Lenoir, T.; Guigui, P.

doi:10.1016/j.otsr.2016.03.012

Cited by 26 publications

(19 citation statements)

References 21 publications

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“…In contrast, the results reported in our study show a radiographically detectable ASD rate of 15% within the segment superior to the dynamic instrumented level and, interestingly, no radiological or clinical signs of ASD or ASDi within the dynamic instrumented level. The prevalence of ASD in the segment cranially adjacent to the dynamic instrumented level (15%) correlates with the incidence of ASD after lumbar spine fusion reported in the literature [ 8 , 9 ]. In this respect, the results show that hybrid lumbar spinal fusion using the CD Horizon BalanC™ rod system is not able to prevent the development of ASD.…”

Section: Discussionmentioning

confidence: 68%

“…The general incidence of ASD varies from 5.2 to 18.5% at 2–5 years after lumbar fusion; however, Moreau et al reported a rate > 20% for degenerative spondylolisthesis at 2 years after lumbar fusion [ 8 , 9 ]. Risk factors for the manifestation of ASD are being > 60 years old, having an increased body mass index, preexisting disc and facet joint degeneration, the length of the fusion, and decreased postoperative lumbar lordosis in the sagittal alignment [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

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Clinical experiences with a PEEK-based dynamic instrumentation device in lumbar spinal surgery: 2 years and no more

Oikonomidis

Ashqar²,

Kaulhausen³

et al. 2018

J Orthop Surg Res

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BackgroundDynamic spine implants were developed to prevent adjacent segment degeneration (ASD) and adjacent segment disease (ASDi). Purpose of this study was to investigate the clinical and radiological outcomes of “topping off” devices following lumbar spinal fusion procedure using a PEEK-based dynamic rod system. Moreover, this study focused on the hypothesis that “topping off” devices can prevent ASD.MethodsThis prospective nonrandomized study included patients with indication for single-level lumbar fusion and radiological signs of ASD without instability. The exclusion criteria were previous lumbar spine surgery and no sign of disc degeneration in the adjacent segment according to magnetic resonance imaging. All patients were treated with single-level lumbar interbody fusion and dynamic stabilization of the cranial adjacent segment. Patients underwent a clinical examination and radiographs preoperatively and at 1 and 2 years after surgery. Analyses were performed on clinical data collected with the German Spine Registry using the core outcome measure index (COMI) and visual analogue scale (VAS) scores for back and leg pain.ResultsA total of 22 patients (6 male and 16 female) with an average age of 57.6 years were included in the study; 20 patients completed the follow-up (FU). The average COMI score was 9.0 preoperatively, 4.2 at the 1-year FU, and 4.7 at the 2-year FU. The average preoperative VAS scores for back and leg pain were 7.7 and 7.1, respectively. At the 1-year FU, the scores were 4.25 for back pain and 2.2 for leg pain, and at the 2-year FU, the scores were 4.7 for back pain and 2.3 for leg pain. At FU, failure of the dynamic topping off implant material was verified in four cases, and ASD of the segment cranial to the topping off was confirmed in three cases.ConclusionsThese results demonstrate significant improvements in clinical outcomes and pain reduction after lumbar spinal fusion with topping off at 2 years after surgery. However, the implant failed due to the high rate of implant failure and the development of ASD in the segment cranial to the dynamic stabilized segment.

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Section: Discussionmentioning

confidence: 68%

Section: Introductionmentioning

confidence: 99%

Clinical experiences with a PEEK-based dynamic instrumentation device in lumbar spinal surgery: 2 years and no more

Oikonomidis

Ashqar²,

Kaulhausen³

et al. 2018

J Orthop Surg Res

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“…Adjacent segment degeneration has been reported to be likely after lumbar fusion surgeries. Moreau et al 22 reported that 29% of patients developed adjacent segment degeneration, which was mainly associated with risk factors such as a high number of instrumented levels and preoperative sagittal imbalance. In their survey on the effects of fusion, D'Oro et al 23 found that lumbar fusion surgery increases the incidence of disc degeneration.…”

Section: Discussionmentioning

confidence: 99%

Quantitative T2 Mapping Shows Increased Degeneration in Adjacent Intervertebral Discs Following Kyphoplasty

et al. 2018

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Objective A minimally invasive treatment of osteoporotic and nonosteoporotic thoracic and lumbar spine fractures is cement augmentation (kyphoplasty). Little is known about the impact on adjacent intervertebral discs. A quantitative magnetic resonance imaging (MRI) approach in addition to morphological MRI is desirable to evaluate changes in the intervertebral disc. Our study aims to evaluate the feasibility of T2 mapping for the detection of subtle changes in the intervertebral discs in spines after kyphoplasty. Design Intervertebral discs were assessed by quantitative MRI (3.0 T) using T2 relaxation time mapping. Region of interest (ROI; 6 per disc) analyses were performed. The ROIs at the anterior and posterior edges were interpreted as annulus fibrosus (AF). The 2 very inner zones were regarded as nucleus pulposus (NP) and the regions in between as intermediate transition zone. We compared T2 relaxation time values of intervertebral discs adjacent to the vertebrae after kyphoplasty with those nonadjacent to vertebrae after kyphoplasty, especially in the NP. Results The analysis of the ROIs showed that the intervertebral discs of the adjacent vertebral segments are associated with reduced T2 values compared to those that are nonadjacent to the affected vertebrae. Conclusion This study is to our knowledge the first investigation of intervertebral discs after kyphoplasty by quantitative MRI. Quantitative T2 mapping shows increased degeneration in adjacent intervertebral discs following kyphoplasty. Besides its contribution to a broader knowledge of postoperative changes after kyphoplasty, our findings may help to improve differentiation between healthy and degenerated intervertebral discs using these techniques.

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“…Lumbar interbody fusion results in loss of movement in a segment and may reduce pain. However, surgical fusion of the lumbar spine may result in an eventual adjacent level arthrosis with symptomatic degeneration warranting additional surgery in 16.5% and 36.1% of patients in 5 and 10 years, respectively 7) ; and an increased risk of need for revision surgery 8) . Direct pars interarticularis repair has the advantage of preserving mobile segments and dealing directly with the anatomical defect.…”

Section: Discussionmentioning

confidence: 99%

Direct reduction and repair of spondylolysis with grade 1 slip using the smiley face rod: a case report

Okuwaki¹,

Tatsumura

Gamada

et al. 2021

J Rural Med

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Radiologic adjacent segment degeneration 2 years after lumbar fusion for degenerative spondylolisthesis

Abstract: IV, retrospective cohort.

Cited by 26 publications

References 21 publications

Clinical experiences with a PEEK-based dynamic instrumentation device in lumbar spinal surgery: 2 years and no more

Clinical experiences with a PEEK-based dynamic instrumentation device in lumbar spinal surgery: 2 years and no more

Quantitative T2 Mapping Shows Increased Degeneration in Adjacent Intervertebral Discs Following Kyphoplasty

Direct reduction and repair of spondylolysis with grade 1 slip using the smiley face rod: a case report

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