A group of researchers recently examined 54 patients undergoing L4/5 posterior lumbar interbody fusion to identify the risk factor for adjacent segment disease and efficacy of simultaneous decompression for symptomatic ASD. The results were published in the Journal of Spinal Disorders & Techniques.
Of the patients included in the study, 37 were treated simultaneously with decompression surgery at L3/4. Seven patients had symptomatic ASD — six in the decompression group and one in the PLIF-only group. According to the study's abstract, local lordosis at the fused segment and the sagittal angle of the facet joint at L3/4 were statistically significant predictors of ASD.
"Patients whose facet joint at the adjacent segment had a more sagittal orientation had postoperative anterior listesis, which caused symptomatic ASD. Simultaneous decompression surgery without fusion at the adjacent level was not effective for these patients, but rather, there was a possibility that it induced symptomatic ASD," concluded the study authors.
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