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KMID : 1099620070040030112
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Korean Journal of Spine
2007 Volume.4 No. 3 p.112 ~ p.116
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Symptomatic Adjacent-segment Degeneration after Lumbar Fusion: a Review of Clinical and Radiologic Studies
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Shin Hee-Sup
Kim Sung-Bum
Lim Young-Jin
Kim Tae-Sung
Kim Sung-Min
Rhee Bong-Arm
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Abstract
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Objectives: Spinal fusion technique has been widely used for spinal stenosis or spondylolisthesis with successful clinical results. However, there are some studies about biomechanical change in the adjacent segment of fused spinal segment, though their changes are difficult to differentiate from natural degenerative changes. This study retrospectively analyzes adjacent segment disease after the advent of spinal fusion technique.
Methods: Thirteen cases between January 2005 and December 2006, which 2nd operation was performed due to an adjacent segment disease occurring after spinal fusion operation, were analyzed. The time of development of adjacent segment disease from the first surgery and the developed sites were evaluated based on medical records and radio- logical findings, in relation to the area and method of the first surgery.
Results: The average time of development of adjacent segment disease from the first fusion surgery was 32.7 months. All of our cases with adjacent segment disease occurred superiorly adjacent to the fixed segment. In 8 cases(61.5%), it occurred in 3-4th lumbar vertebrae, and in 5 cases(38.4%) 2-3rd lumbar vertebrae respectively. Of the 8 cases where the disease occurred in 3-4th lumbar vertebrae, in 6 cases the disease occurred after fusion of 4-5th lumbar vertebrae, in 2 cases after fusion of 4-5th lumbar and 1st sacral vertebrae respectively. Of the 5 cases where the disease occurred in 2-3rd lumbar vertebrae, the disease occurred after fusion of 3-4-5th lumbar vertebrae in 3 cases, and after fusion of 3rd and 4th lumbar vertebrae in 2 cases respectively.
Conclusion: This study analyzed adjacent segment disease that occurred adjacent to fusion sites after spinal fusion surgery. Although the small number of cases analyzed, the study result showed that the average time of development of adjacent segment disease after the first fusion is 32.7 months. For more accurate study of adjacent segment disease, further retrospective analysis based on more clinical cases is required.
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KEYWORD
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Lumbar, Spinal stenosis, Adjacent-segment degeneration
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