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Incidence and risk factors of distal adjacent disc degeneration in adolescent idiopathic scoliosis patients undergoing fusion surgery: a systematic review and meta-analysis – Lumbar Fusion

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This meta-analysis aimed to investigate the incidence of disc degeneration in patients with surgically treated adolescent idiopathic scoliosis (AIS) and identify associated risk factors. The analysis included nine studies with a total of 565 patients and found that the global incidence of disc degeneration was 24.78% at 10 years post-surgery, increasing to 32.32% at an average of 13.8 years after surgery. Patients with significant disc degeneration had worse functional outcomes. Instrumentation at or above the L3 level was associated with a lower incidence of disc degeneration. Incomplete correction of deformity and fusion of levels below L3 were identified as negative prognostic factors. Overall, the study concluded that disc degeneration significantly increased with long-term follow-up using fusion techniques, reaching up to 32% by the age of 28 years

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
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Published article

S: This meta-analysis demonstrated that the incidence of intervertebral disc degeneration significantly increased with long-term follow-up using fusion techniques, reaching up to 32% when patients were 28 years of age. Incomplete correction of deformity and fusion of levels below L3, were identified as negative prognostic factors. Furthermore, patients with disc degeneration showed worse functional outcomes.

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Eur Spine J. 2024 Feb 19. doi: 10.1007/s00586-024-08165-1. Online ahead of print.ABSTRACTPURPOSE: The objective of this meta-analysis was to determine the incidence of disc degeneration in patients with surgically treated adolescent idiopathic scoliosis (AIS) and identify the associated risk factors.METHODS: PubMed, EMBASE, Scopus, and Cochrane Collaboration Library databases were searched. The outcomes of interest were,

Eur Spine J. 2024 Feb 19. doi: 10.1007/s00586-024-08165-1. Online ahead of print.

ABSTRACT

PURPOSE: The objective of this meta-analysis was to determine the incidence of disc degeneration in patients with surgically treated adolescent idiopathic scoliosis (AIS) and identify the associated risk factors.

METHODS: PubMed, EMBASE, Scopus, and Cochrane Collaboration Library databases were searched. The outcomes of interest were the incidence of disc degeneration, SRS-22, and radiological risk factors. The lower instrumented vertebra (LIV) was also evaluated. Fixed effects were used if there was no evidence of heterogeneity. Statistical analysis was performed using Review Manager.

RESULTS: A meta-analysis was conducted including nine studies with a total of 565 patients. The analysis revealed that the global incidence of intervertebral disc degeneration in patients with surgically treated AIS patients was 24.78% (95% CI 16.59-32.98%) 10 years after surgery, which significantly increased to 32.32% (95% CI 21.16-43.47% at an average of 13.8 years after surgery. Among patients with significant degenerative disc changes, the SRS-22 functional, self-image, and satisfaction domains showed significantly worse results (MD – 0.25, 95% CI – 0.44 to – 0.05; MD – 0.50, 95% CI – 0.75 to – 0.25; and MD – 0.34, 95% CI – 0.66 to – 0.03, respectively). Furthermore, instrumentation at or above the L3 level was associated with a lower incidence of intervertebral disc degeneration compared to instrumentation below the L3 level (OR 0.25, 95% CI 0.10-0.64). It was also found that the preoperative and final follow-up lumbar curve magnitudes (MD 8.11, 95% CI 3.82-12.41) as well as preoperative and final follow-up lumbar lordosis (MD 0.42, 95% CI – 3.81 to 4.65) were associated with adjacent disc degeneration.

S: This meta-analysis demonstrated that the incidence of intervertebral disc degeneration significantly increased with long-term follow-up using fusion techniques, reaching up to 32% when patients were 28 years of age. Incomplete correction of deformity and fusion of levels below L3, were identified as negative prognostic factors. Furthermore, patients with disc degeneration showed worse functional outcomes.

PMID:38372794 | DOI:10.1007/s00586-024-08165-1

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Incidence and risk factors of distal adjacent disc degeneration in adolescent idiopathic scoliosis patients undergoing fusion surgery: a systematic review and meta-analysis

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Eur Spine J. 2024 Feb 19. doi: 10.1007/s00586-024-08165-1. Online ahead of print.ABSTRACTPURPOSE: The objective of this meta-analysis was to determine the incidence of disc degeneration in patients with surgically treated adolescent idiopathic scoliosis (AIS) and identify the associated risk factors.METHODS: PubMed, EMBASE, Scopus, and Cochrane Collaboration Library databases were searched. The outcomes of interest were

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