Isthmic spondylolisthesis is associated with less revisions for adjacent segment disease after lumbar spine fusion than degenerative spinal conditions - A 10-year follow-up study

Toivonen, Leevi; Mäntymäki, Heikki; Häkkinen, Arja; Neva, Marko H.

doi:10.1016/j.bas.2021.100214

Cited by 2 publications

(3 citation statements)

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“…ASD is a major cause for a second operation after lumbar spinal fusion surgery 8,29) . A systematic review revealed that the incidence of radiologically diagnosed adjacent segment degeneration ranged from 5.3% to 100% during 36 to 369 months of follow-up.…”

Section: Issues Of Adjacent Segment Degenerationmentioning

confidence: 99%

“…The incidence of symptomatic ASD ranged from 5.2% to 18.5% during 44.8 to 164 months of fol-low-up 21,32) . Okuda et al 20) and Toivonen et al 29) demonstrated that the rates of radiologically assessed adjacent segment degeneration at 2, 5, and 10 years were 19%, 49%, and 79%, respectively, after primary posterior lumbar interbody fusion (PLIF) surgery. Several potential risk factors are linked to the progression of adjacent segment degeneration, such as age, genetic factors, pre-existing adjacent segment degeneration or stenosis, laminectomy at the adjacent level of fusion, osteoporosis, and poor sagittal balance 8,29) .…”

Section: Issues Of Adjacent Segment Degenerationmentioning

confidence: 99%

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The Influence of Spondylolisthesis Reduction on the Adjacent Lumbar Segment

Park,

Choi,

Kim

et al. 2023

Nerve

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Objective: Mild to moderate stenosis at the adjacent level sometimes co-occurs with lumbar spondylolisthesis, but whether to include the adjacent level during surgery for the index level is a matter of debate. Spondylolisthesis causes anterior slipping of the vertebra and reduces the segmental angle at the index level, and the adjacent level may compensate for this change through hyperextension to maintain spinal balance. This study investigated the radiological changes and clinical outcomes of adjacent segment stenosis in patients with lumbar spondylolisthesis. Methods: Forty consecutive patients (12 men and 28 women, age 66.6±10.4 years) underwent single-level oblique lumbar interbody fusion for L4-5 or L5-S1 spondylolisthesis. Lumbar central stenosis at the cranial adjacent segment was present in 16 patients (stenosis group) and absent in 24 patients (no-stenosis group). Clinical and radiological parameters were longitudinally compared between the stenosis and no-stenosis groups. Results: Both groups showed similar and significant clinical improvement. The segmental angle at the index level significantly improved in both groups (p<0.05), but the segmental angle at the cranial adjacent segment significantly decreased only in the stenosis group (p<0.05). The spinal canal area at the adjacent level significantly improved only in the stenosis group (p<0.05). Conclusion: Realigned spondylolisthesis may reduce hyperextension of the adjacent segment. If mild lumbar spinal stenosis is present at an adjacent level to spondylolisthesis, it may not be essential to include it in surgery.

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Section: Issues Of Adjacent Segment Degenerationmentioning

confidence: 99%

Section: Issues Of Adjacent Segment Degenerationmentioning

confidence: 99%

The Influence of Spondylolisthesis Reduction on the Adjacent Lumbar Segment

Park,

Choi,

Kim

et al. 2023

Nerve

View full text Add to dashboard Cite

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“…(2) We presented the (average) 10-year ASD revision rate of 20.5% for our degenerative patients in the previous study. 4 The hazard ratios are proportional to this. (3) Hazard ratios for patients aged <65 and ≥ 65 years were 2.07 (95% CI: 0.45-9.57) and 1.43 (95% CI: 0.67-3.04), respectively, both remaining insignificant.…”

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confidence: 99%