A modified method to treat severe asymptomatic pre-existing degeneration of adjacent segment: a retrospective case-control study.
BMC Surg
; 21(1): 161, 2021 Mar 23.
Article
en En
| MEDLINE
| ID: mdl-33757478
ABSTRACT
BACKGROUND:
Pre-existing degeneration of adjacent segment is an important risk factor for adjacent-segment degeneration (ASD), but only limited and controversial studies have addressed its management.METHODS:
We retrospectively analyzed patients with symptomatic degeneration of the L5/S1 segment warranting surgical interference and severe asymptomatic degeneration of the L4/5 segment. Of these patients, those who underwent interbody fusion of the causative (L5/S1) segment and distraction of the intervertebral space and facet fusion of the adjacent L4/5 segment were included in Group A (n = 103), while those who underwent interbody fusion of both the L5/S1 and L4/5 segments were included in Group B (n = 81). Clinical and radiographic outcomes were evaluated.RESULTS:
Mean follow-up time was 58.5 months (range, 48-75 months). We found no significant difference in clinical outcomes or incidence of ASD in the L3/4 segment between Groups A and B. Compared with Group B, Group A experienced less bleeding (315 ± 84 ml vs. 532 ± 105 ml), shorter operation time (107 ± 34 min vs. 158 ± 55 min) and lower costs (US $13,830 ± $2640 vs. US $16,020 ± $3380; P < 0.05). In Group A, the disc height ratio (DHR) of the L4/5 segment was significantly increased from a preoperative value of 0.40 ± 0.13 to a last-follow-up value of 0.53 ± 0.18 (P < 0.05), while the degree of canal stenosis (DCS) was decreased from a preoperative value of 34.3 ± 11.2% to a last-follow-up value of 15.9 ± 9.3 % (P < 0.05).CONCLUSIONS:
This modified method could be effective in treating severe asymptomatic pre-existing degeneration of adjacent segment in the lumbar spine.Palabras clave
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Fusión Vertebral
/
Degeneración del Disco Intervertebral
/
Vértebras Lumbares
Tipo de estudio:
Observational_studies
Límite:
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
BMC Surg
Año:
2021
Tipo del documento:
Article
País de afiliación:
China