A new study published in Spine examines adjacent segment disease risk factors for patients 10 years or more after posterior lumbar interbody fusion.
The study authors examined patients with disc degeneration and spinal stenosis on an MRI to identify risk factors for developing early-onset radiographical adjacent segment disease using the multivariate logistic regression analysis.
The researchers found:
1. Ten years after surgery, the patients showed at the caudal-adjacent level:
• Changes in disc height: 12 cases
• Vertebral slip: 36 cases
• Intervertebral angle on radiographs: 17 cases
2. At the cranial-adjacent level, increased disc degeneration was noticed in 62 cases and spinal stenosis worsened in 68 cases.
3. At the caudal-adjacent level, there was increased disc degeneration for 25 patients and worsening spinal stenosis in 12 cases 10 years after surgery.
4. There were 10 patients — 9.9 percent — who required reoperations. Eighty percent of the revision surgeries were performed more than five years after the initial surgery.
5. The researchers found high pelvic incidence was a risk factor for developing the early onset radiographical adjacent segment disease.
"Obtaining appropriate lumbar lordosis in PLIF is important for preventing ASD," concluded the study authors.