Incidence and risk factors of reoperation in patients with adjacent segment disease: A meta-analysis

Burch, M. Benjamin; Wiegers, Nicholas W; Patil, Sachin S.; Nourbakhsh, Ali

doi:10.4103/jcvjs.jcvjs_10_20

Cited by 25 publications

(19 citation statements)

References 86 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…This separation of the 2 terms is often because radiologic findings of ASDeg may not correlate with the clinical symptoms of the patient, and therefore, ASDis is usually examined in the context of the patient's clinical symptoms 32 . This difference is highlighted in a 217-patient study by Abraham et al where the incidence of radiological ASDeg was found to be 29%, whereas the incidence of clinical ASDis was only 18% 33 .…”

Section: Radiographic Assessmentmentioning

confidence: 99%

“…This corroborates with Kim et al who found that patients with a postoperative L4-S1/L1-S1 lordosis ratio greater than 50% had less occurrence of ASDis 35 . A study looking in part at ASDis in the thoracic spine found that larger preoperative thoracic kyphosis and larger immediate postoperative thoracic kyphosis correction were risk factors for reoperation due to ASDis 32 .…”

Section: Radiographic Assessmentmentioning

confidence: 99%

See 1 more Smart Citation

Adjacent Segment Disease After Spinal Fusion

et al. 2023

View full text Add to dashboard Cite

Adjacent segment disease is characterized by a degenerative process adjacent to a previously fused spine segment, with new onset of clinical symptoms such as radiculopathy, myelopathy, or instability.Etiology is related to the natural history of the disease process, increased biomechanical stress at adjacent segments, clinical factors specific to the individual patient, intraoperative factors, and malalignment.Treatment is usually nonoperative, but surgical intervention can be indicated. Decompression and fusion remain the mainstay of operative treatment, and isolated decompression should be considered in specific cases.Further randomized controlled trials are needed to establish how the treatment should progress, particularly with the development of minimally invasive and endoscopic surgery.

show abstract

Section: Radiographic Assessmentmentioning

confidence: 99%

Section: Radiographic Assessmentmentioning

confidence: 99%

Adjacent Segment Disease After Spinal Fusion

et al. 2023

View full text Add to dashboard Cite

show abstract

“…The unplanned re-operation rate has been studied in many surgical sub-fields, including general surgery [ 7 ], vascular surgery [ 8 ], plastic surgery [ 9 ], neurosurgery [ 10 - 12 ], and orthopedic surgery [ 13 - 15 ]. There are studies evaluating unplanned re-operation rates in adult upper extremity surgery [ 16 ], but few focused on the pediatric population.…”

Section: Introductionmentioning

confidence: 99%

Risk Factors for 30-Day Unplanned Re-Operation in Pediatric Upper Extremity Surgery: A National Surgical Quality Improvement Program (NSQIP)-Pediatric Analysis

Chiu¹,

Quan²,

Kraft³

et al. 2023

Cureus

View full text Add to dashboard Cite

“…As the number of individuals undergoing lumbar spinal fusion has dramatically increased in recent decades, so too has the incidence of ASD [2][3][4]. The incidence is estimated to be between 2 to 4% per year in both the lumbar and cervical spine [1].…”

Section: Introductionmentioning

confidence: 99%

“…The incidence is estimated to be between 2 to 4% per year in both the lumbar and cervical spine [1]. Based on meta-analysis, it is reported that 8% of patients will require reoperation secondary to ASD following spinal fusion over an average follow-up period of 6.4 years [2]. However, reoperation rates vary considerably with studies reporting up to 36% of ASD patients undergoing reoperation at 10 years [5].…”

Section: Introductionmentioning

confidence: 99%

Novel Applications of Robot-Assisted Navigation in the Treatment of Lumbar Adjacent Segment Disease: A Case Series

BS¹,

Lee-Norris²,

Reddy³

2023

Act Scie Neuro

View full text Add to dashboard Cite

Objective: The treatment of adjacent segment disease (ASD) following lumbar fusion is common and often requires reoperation.Traditionally, reoperation requires revision and exposure of prior instrumentation, and removal of this hardware increases operative time and perioperative risks. The authors report on the use of robot-assisted navigation (RAN) to accomplish minimally-invasive posterior pedicle screw fixation, including pedicle re-instrumentation when needed, to treat ASD and avoid revision and exposure of prior hardware. Methods:A retrospective review of five patients treated for lumbar ASD with posterior fixation was conducted. All screw trajectories were planned preoperatively using the robotic software. All patients underwent minimally-invasive decompression and transforaminal lumbar interbody fusion followed by robot-assisted pedicle screw placement for fixation. Basic demographics, operative indications, pre-operative planning data, perioperative outcomes and short-term clinical outcomes were evaluated. Results:The mean age was 71.2 years, mean total operative time was 117.6 minutes (range: 98 -140 minutes), mean operative time per screw was 27.2 minutes, mean estimated blood loss was 30mL (range: 25 -50 mL), mean body mass index was 36.64 (range: 26.7 -46.9), and mean length of stay was 1.2 days (range: 1-2 days). A total of six screws were placed in previously instrumented pedicles without removing prior hardware, four in a cortical bone trajectory and two in a transpedicular trajectory (TPT). In one patient with both distal and proximal ASD, pedicle re-instrumentation was avoided altogether, creating a construct caudal, rostral and medial to index fusion. Patients were successfully treated for both single-and multi-level ASD. There were no perioperative complications. One patient was lost to follow-up. The remaining four patients had acceptable outcomes at short-term clinical follow-up. Conclusion:The authors present a novel application of RAN for the treatment of ASD which obviates the need for revision of prior hardware. To our knowledge, this is the first report of multilevel ASD treatment that avoided revision, as well as the first report of pedicle re-instrumentation in a TPT adjacent to a prior transpedicular screw. This method maintained low operative time and acceptable perioperative outcomes. RAN may offer a minimally-invasive and effective treatment option for patients with ASD that avoids revision of prior hardware and reduces perioperative risk. Long-term clinical outcomes are warranted to ensure clinical and biomechanical durability.

show abstract

Incidence and risk factors of reoperation in patients with adjacent segment disease: A meta-analysis

Cited by 25 publications

References 86 publications

Adjacent Segment Disease After Spinal Fusion

Adjacent Segment Disease After Spinal Fusion

Risk Factors for 30-Day Unplanned Re-Operation in Pediatric Upper Extremity Surgery: A National Surgical Quality Improvement Program (NSQIP)-Pediatric Analysis

Novel Applications of Robot-Assisted Navigation in the Treatment of Lumbar Adjacent Segment Disease: A Case Series

Contact Info

Product

Resources

About