19 Harley St, London, W1G 9QJ, UK

Long-term magnetic resonance imaging follow-up demonstrates minimal transitional level lumbar disc degeneration after posterior spine fusion for adolescent idiopathic scoliosis

STUDY DESIGN: Retrospective cohort study. OBJECTIVE: To describe long-term clinical and imaging results focusing on the uninstrumented lumbar spine after posterior spinal fusion for adolescent idiopathic scoliosis. SUMMARY OF BACKGROUND DATA: Although previous studies found rates of low back pain after long fusion for adolescent idiopathic scoliosis which are comparable to rates found in the general population, many surgeons believe that the long lever arm associated with the fusion mass will result in increased stress at uninstrumented caudal intervertebral discs and accelerated degenerative changes. METHODS: This is a retrospective chart and imaging review of adolescent idiopathic scoliosis patients treated with posterior fusion and segmental instrumentation. Patients completed follow-up examination, outcome questionnaires, radiographs, and magnetic resonance (MR) imaging. MR images were scored for evidence of degeneration of lumbar discs below the level of the fusion. RESULTS: Twenty patients participated in the study, providing 90 discs below fusions for evaluation. The average follow-up was 11.8 years. The distal level of fixation was at L1 on average. The major curve averaged 55 degrees +/- 11 degrees before surgery and was corrected to 25 degrees +/- 10 degrees at follow-up. Follow-up MR imaging demonstrated new disc pathology in 85% of patients enrolled. Only one patient demonstrated significant degenerative disc disease at the junctional level, whereas most pathology was seen at the L5-S1 disc. The average Pfirrmann grade at uninstrumented levels deteriorated from 1.1 before surgery to 1.8 at follow-up. The greatest degree of degeneration was seen at the L5-S1 disc space where average degenerative scores increased from 1.2 before surgery to 2.3 after surgery. Three patients with severe disc disease were taking nonsteroidal anti-inflammatory drugs for pain, but no narcotics. Only mild scoliosis research society (SRS) and Oswestry changes were noted in this severe degeneration group. CONCLUSION: Despite demonstrating an accelerated rate of L5-S1 disc degeneration, our study group has good functional scores and maintenance of correction over 10 years postfusion. In this long-term MR imaging follow-up study, disc degeneration was found remote to the lowest instrumented vertebra

Keywords : Adolescent,Adult,Arm,Back,Back Pain,Cohort Studies,diagnosis,diagnostic imaging,Follow-Up Studies,Humans,instrumentation,Intervertebral Disc,Intervertebral Disc Degeneration,Low Back Pain,Lumbar Vertebrae,Magnetic Resonance Imaging,methods,Middle Aged,Narcotics,Pain,pathology,Patients,Radiography,Retrospective Studies,Scoliosis,Spinal Fusion,Spine,surgery,Surveys and Questionnaires,Time Factors,Treatment Outcome,Young Adult,, Term,Mri,Followup,Demonstrates,Minimal, physical therapist london

Date of Publication : 2011 Nov 1

Authors : Green DW;Lawhorne TW;Widmann RF;Kepler CK;Ahern C;Mintz DN;Rawlins BA;Burke SW;Boachie-Adjei O;

Organisation : Pediatric Orthopaedic Service, Hospital for Special Surgery, New York, NY 10021, USA. greendw@hss.edu

Journal of Publication : Spine (Phila Pa 1976 )

Pubmed Link : https://www.ncbi.nlm.nih.gov/pubmed/21289549

The London Spine Unit : Harley Street UK. Specialists in Cutting Edge Technologies for Spinal Surgery

Make an Appointment 

Trustpilot Reviews
Doctify Reviews
Top Doctor Reviews

Long Term MRI Follow-up Demonstrates Minimal Transitional Level Lumbar Disc Degeneration after Posterior Spine Fusion for Adolescent Idiopathic Scoliosis | Medico legal report

What our patients say ...

Consultant Spine Surgeon
Consultant Spine Surgeon
Consultant Spine Surgeon

This surgical technique consists of a percutaneous approach for the treatment of small to medium size hernias of the intervertebral disc by laser energy. The main objective is to reduce the intradiscal pressure in the nucleus pulposus

Laser Disc Surgery can be performed under local anaesthetic as a day case at our centre on the prestigious Harley Street.
What is London spine unit and How it Works

The London Spine Unit was established in 2005 and has successfully treated over 5000 patients. All conditions are treated.

treatment of all spinal disorders

The London Spine Unit specialises in Minimally Invasive Treatments allowing rapid recovery and return to normal function

Trusted by patients worldwide

The London Spine Unit provides the highest quality care to all patients and has VIP services for those seeking exceptional services

If you have any emergency Doctor’s need, simply call our 24 hour emergency

Your personal case manager will ensure that you receive the best possible care.

Call Now 

+44 844 589 2020
+44 203 973 8810