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Prediction Model and Risk Factor Analysis of Adjacent Segment Disease After L4-5 Transforaminal Lumbar Interbody Fusion Through Preoperative Radiographic Features – Lumbar Fusion

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The article discusses a retrospective study conducted to investigate the risk of adjacent segment disease (ASD) after L4-5 transforaminal lumbar interbody fusion (TLIF) in patients with lumbar spinal stenosis (LSS). The study collected data from 290 patients who underwent L4-5 TLIF and analyzed baseline data and preoperative radiographic features. The results identified independent risk factors for degeneration at L3-4 and L5-S1, including osteoarthritis, foraminal stenosis, spinal stenosis, and intervertebral disc degeneration. The study developed a predictive model, with high accuracy and consistency, to aid clinicians in making surgical decisions by providing a valuable auxiliary decision-making system

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : most experienced spinal hospital in London

Published article

: This study established nomograms for postoperative degeneration at L3-4 and L5-S1 based on selected preoperative radiographic features. These models provide a valuable auxiliary decision-making system for clinicians and aid in early surgical decisions.

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Global Spine J. 2024 Feb 6:21925682241231764. doi: 10.1177/21925682241231764. Online ahead of print.ABSTRACTSTUDY DESIGN: A retrospective study.OBJECTIVE: To investigate the risk of adjacent segment disease (ASD) after L4-5 transforaminal lumbar interbody fusion (TLIF) in patients diagnosed with lumbar spinal stenosis (LSS), a prediction model for ASD is established and validated.METHODS: A retrospective study was carried out,

Global Spine J. 2024 Feb 6:21925682241231764. doi: 10.1177/21925682241231764. Online ahead of print.

ABSTRACT

STUDY DESIGN: A retrospective study.

OBJECTIVE: To investigate the risk of adjacent segment disease (ASD) after L4-5 transforaminal lumbar interbody fusion (TLIF) in patients diagnosed with lumbar spinal stenosis (LSS), a prediction model for ASD is established and validated.

METHODS: A retrospective study was carried out on a sample of 290 patients who underwent L4-5 TLIF at Zhongda Hospital, Southeast University, from January 2015 to January 2021. The study collected baseline data and preoperative radiographic features of L3-4 and L5-S1. The determination of the outcome variable was based on X-ray results spanning over 24 months and JOA scores. Multivariate logistic regression was used to identify the risk factors in constructing a nomogram.

RESULTS: Independent risk factors for L3-4 degeneration after TLIF included osteoarthritis of L3-4 facet joints, L3-4 foraminal stenosis, L4 upper endplate osteochondritis, L3-4 local lordosis angle, and L3-4 spinal stenosis. Independent risk factors for L5-S1 degeneration after TLIF included osteoarthritis of L5-S1 facet joints, L5-S1 intervertebral disc degeneration, L5-S1 spinal stenosis, L5-S1 coronal imbalance, and S1 upper endplate osteochondritis. A predictive model was developed. The AUC for the prediction models at L3-4 and L5-S1 were .945 and .956. The calibration curve demonstrated good consistency between the predicted and actual probabilities. The DCA curve indicated the clinical benefit and practical value of this predictive model.

: This study established nomograms for postoperative degeneration at L3-4 and L5-S1 based on selected preoperative radiographic features. These models provide a valuable auxiliary decision-making system for clinicians and aid in early surgical decisions.

PMID:38321379 | DOI:10.1177/21925682241231764

The London Spine Unit : most experienced spinal hospital in London

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Prediction Model and Risk Factor Analysis of Adjacent Segment Disease After L4-5 Transforaminal Lumbar Interbody Fusion Through Preoperative Radiographic Features

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Global Spine J. 2024 Feb 6:21925682241231764. doi: 10.1177/21925682241231764. Online ahead of print.ABSTRACTSTUDY DESIGN: A retrospective study.OBJECTIVE: To investigate the risk of adjacent segment disease (ASD) after L4-5 transforaminal lumbar interbody fusion (TLIF) in patients diagnosed with lumbar spinal stenosis (LSS), a prediction model for ASD is established and validated.METHODS: A retrospective study was carried out
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