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KMID : 0922220090090020098
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Journal of the Korean Musculoskeletal Transplantation Society
2009 Volume.9 No. 2 p.98 ~ p.106
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Adjacent Segment Degeneration and Pelvic Incidence after Lumbar Fusion
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Nah Ki-Ho
Ha Kee-Yong
Rhyu Kee-Won
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Abstract
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Purpose: A retrospective study to evaluate the influence of the pelvic anatomy on the adjacent segment degeneration after lumbar fusion.
Materials and Methods: We evaluated 97 lumbar spinal stenosis patients treated with posterior decompression and fusion. Mean follow-up period was 33 months (range, 24~55 months). Pelvic and lumbar parameters, and the upper adjacent segment parameters (segmental angle and angular instability) were measured. The patients were subgrouped into group 1 (pelvic incidence < 60˚), and group 2 (pelvic incidence ≥ 60˚). Clinical results were evaluated with Oswestry disability index.
Results: The adjacent segmental angle became more kyphotic as the pelvic incidence was larger (r=0.271, p<0.05), and became more kyphotic in group 2 than group 1 (p=0.001). There was a tendancy that the adjacent segment become more unstable as Pelvic incidence was larger, and in group 2 than group 1, however it was statistically insignificant. Clinical results showed no difference between the two groups (p=0.928).
Conclusion: Lumbar fusion surgery should be performed cautiously in patients with large pelvic incidence, especially in patients with pelvic incidence more than 60?, which would accelerate the upper adjacent segment degeneration.
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KEYWORD
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Lumbar fusion, Adjacent segment degeneration, Pelvic incidence
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