2000
DOI: 10.1097/00007632-200007010-00004
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The Biomechanical Effect of Postoperative Hypolordosis in Instrumented Lumbar Fusion on Instrumented and Adjacent Spinal Segments

Abstract: Hypolordosis in the instrumented segments caused increased loading of the posterior column of the adjacent segments. These biomechanical effects may explain the degenerative changes at the junctional level that have been observed as long-term consequences of lumbar fusion.

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Cited by 254 publications
(151 citation statements)
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“…However, adjacent segment degeneration (ASD) has been reported as a long-term complication with an incidence ranging from 10 to 100% [15,16]. The overall revision rate for symptomatic ASD ranges from 2.7 to 20% [17]. Since the 1980s, non-rigid, dynamic implants have been studied in an attempt to reduce ASD.…”
Section: Discussionmentioning
confidence: 99%
“…However, adjacent segment degeneration (ASD) has been reported as a long-term complication with an incidence ranging from 10 to 100% [15,16]. The overall revision rate for symptomatic ASD ranges from 2.7 to 20% [17]. Since the 1980s, non-rigid, dynamic implants have been studied in an attempt to reduce ASD.…”
Section: Discussionmentioning
confidence: 99%
“…These post-operative pain patterns have been linked to increased stress distribution and motion adjacent to the fused segments as well as to pathologically altered lumbar segmental, sagittal and spinopelvic alignment [1,21,29,32,35,42,43,63]. The reported incidence of symptomatic ''fusion-related'' pain patterns from posterior joint structures ranges from 32 to 61%, and it's clinical relevance has been confirmed in a variety of studies using fluoroscopically guided spine infiltrations [29,42,43].…”
Section: Introductionmentioning
confidence: 97%
“…Although most often the criteria to determine ASD are based solely on radiographic findings [2,7,19,28,30,34,39,41,59] reporting an ASD incidence ranging from 8 to 100%, the symptomatic incidence of ASD is significantly lower ranging from 5.2 to 18.5% [7,28,31], while the rate of re-operation rate for symptomatic ASD ranges from 2.7 to 20% [16,58].…”
Section: Introductionmentioning
confidence: 99%
“…There is a controversy regarding the risk factors involved in the development of ASD [2,11,12,22,28,40,41,47,[57][58][59]. Non-rigid, dynamic or flexible instrumentations for lumbar spine have been developed to reduce ASD [17,18,27].…”
Section: Introductionmentioning
confidence: 99%