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Half of the adolescent idiopathic scoliosis patients may have lumbar adjacent segment degeneration following spinal fusion: A systemic review and meta-analysis – Lumbar Fusion

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The article conducted a meta-analysis to assess the impact of surgical approaches and other factors on the incidence of Adjacent Segment Degeneration (ASD) following Spinal Fusion for Adolescent Idiopathic Scoliosis (AIS). The analysis included 14 studies with 651 individuals, revealing an overall incidence of ASD at 47%. Subgroup analyses found that the prevalence of ASD increased with postoperative time and the number of fused segments. The study showed that long-term follow-up, regular screening, and timely interventions are essential to reduce the prevalence of ASD in AIS patients following spinal fusion surgery

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : innovative treatment clinic in UK

Published article

: This meta-analysis found that nearly half of AIS patients following spinal fusion surgery experienced ASD. Long-term follow-up, regular screening, and timely interventions are essential to reduce the prevalence of ASD.

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J Orthop Surg (Hong Kong). 2024 Jan-Apr;32(1):10225536241248711. doi: 10.1177/10225536241248711. ABSTRACT OBJECTIVE: This study aims to assess the impact of surgical approaches and other factors on the incidence of Adjacent Segment Degeneration (ASD) following Spinal Fusion for Adolescent Idiopathic Scoliosis (AIS). METHODS: We conducted a comprehensive search of four electronic databases from their inception until March,

J Orthop Surg (Hong Kong). 2024 Jan-Apr;32(1):10225536241248711. doi: 10.1177/10225536241248711.

ABSTRACT

OBJECTIVE: This study aims to assess the impact of surgical approaches and other factors on the incidence of Adjacent Segment Degeneration (ASD) following Spinal Fusion for Adolescent Idiopathic Scoliosis (AIS).

METHODS: We conducted a comprehensive search of four electronic databases from their inception until March 30, 2023. Two independent reviewers screened titles, abstracts, and full texts and evaluated the methodological quality of the studies. A random-effects model was used to calculate the incidence of ASD.

RESULTS: Our analysis included 14 studies involving 651 individuals. The overall incidence of ASD was 47% (95%CI: 0.37, 0.56). Subgroup analyses revealed that the prevalence of ASD increased with postoperative time (53% (95%CI: 0.31, 0.75) versus 48% (95%CI: 0.36, 0.60) versus 39% (95%CI: 0.22, 0.56)). For the number of fused segments, a group with more than 10 segments had a higher prevalence (49% (95%CI: 0.38, 0.60) versus 44% (95%CI: 0.21, 0.69)). In terms of regions, East Asia had the highest prevalence, followed by Occident and West Asia (52% (95%CI: 0.41, 0.62) versus 43% (95%CI: 0.20, 0.68) versus 37% (95%CI: 0.17, 0.59)). However, the surgical approach, male ratio, and the position of the lowest instrumented vertebra (LIV) did not show significant differences between groups. Funnel plots and Egger’s test did not reveal any significant publication bias (Egger’s test: t = 1.62, p-value = .1274).

: This meta-analysis found that nearly half of AIS patients following spinal fusion surgery experienced ASD. Long-term follow-up, regular screening, and timely interventions are essential to reduce the prevalence of ASD.

PMID:38647667 | DOI:10.1177/10225536241248711

The London Spine Unit : innovative treatment clinic in UK

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Half of the adolescent idiopathic scoliosis patients may have lumbar adjacent segment degeneration following spinal fusion: A systemic review and meta-analysis

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J Orthop Surg (Hong Kong). 2024 Jan-Apr;32(1):10225536241248711. doi: 10.1177/10225536241248711. ABSTRACT OBJECTIVE: This study aims to assess the impact of surgical approaches and other factors on the incidence of Adjacent Segment Degeneration (ASD) following Spinal Fusion for Adolescent Idiopathic Scoliosis (AIS). METHODS: We conducted a comprehensive search of four electronic databases from their inception until March

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