A study published in Spine examines the characteristics that could predispose patients to adjacent segment disease after lumbar fusion.
There were 137 patients who were included in the study. The patients were undergoing primary lumbar fusion. The researchers found 9 percent required a follow-up operation due to adjacent segment disease. Additional findings include:
1. The adjacent segment disease group had an average of 21.1 months follow-up before the second surgery; the overall follow-up was 41 months.
2. Antidepressant use was a significant predictor of adjacent segment disease development. The additional predictors include:
• Degenerative scoliosis diagnosis
• L4-S1 fusion
• No decompressions adjacent to fusion
• Low sacral slope
3. None of the patients with a decompression adjacent to the fusion reported adjacent segment disease.
4. The study authors concluded, "The awareness of these risk factors may allow for better patient selection and surgical technique to decrease the probability of acquiring this adverse outcome."