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Risk factors for early-onset adjacent segment degeneration after one-segment posterior lumbar interbody fusion – Lumbar Spinal Stenosis

The article explores the risk factors for early-onset adjacent segment degeneration (ASD) following posterior lumbar interbody fusion (PLIF) surgery. A retrospective study of 170 patients with L4 degenerative spondylolisthesis who underwent one-segment PLIF revealed that preoperative larger % slip, vertebral bone marrow edema at the cranial segment on preoperative MRI, and surgical disc space distraction were significant independent risk factors for early-onset ASD. Patients with preoperative imaging findings of bone marrow edema at the cranial segment had a high rate of early-onset ASD. The study suggests that careful consideration is needed for fusion surgery if vertebral bone marrow edema at the cranial segment adjacent to the fusion segment is detected on preoperative MRI

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
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Published article

Adjacent segment degeneration (ASD) is a major postoperative complication associated with posterior lumbar interbody fusion (PLIF). Early-onset ASD may differ pathologically from late-onset ASD. The aim of this study was to identify risk factors for early-onset ASD at the cranial segment occurring within 2 years after surgery. A retrospective study was performed for 170 patients with L4 degenerative spondylolisthesis who underwent one-segment PLIF. Of these patients, 20.6% had early-onset ASD at…

Lumbar Decompression Surgery Expert. Best Spinal Surgeon UK
Sci Rep. 2024 Apr 21;14(1):9145. doi: 10.1038/s41598-024-59924-5. ABSTRACT Adjacent segment degeneration (ASD) is a major postoperative complication associated with posterior lumbar interbody fusion (PLIF). Early-onset ASD may differ pathologically from late-onset ASD. The aim of this study was to identify risk factors for early-onset ASD at the cranial segment occurring within 2 years after surgery.,

Sci Rep. 2024 Apr 21;14(1):9145. doi: 10.1038/s41598-024-59924-5.

ABSTRACT

Adjacent segment degeneration (ASD) is a major postoperative complication associated with posterior lumbar interbody fusion (PLIF). Early-onset ASD may differ pathologically from late-onset ASD. The aim of this study was to identify risk factors for early-onset ASD at the cranial segment occurring within 2 years after surgery. A retrospective study was performed for 170 patients with L4 degenerative spondylolisthesis who underwent one-segment PLIF. Of these patients, 20.6% had early-onset ASD at L3-4. In multivariate logistic regression analysis, preoperative larger % slip, vertebral bone marrow edema at the cranial segment on preoperative MRI (odds ratio 16.8), and surgical disc space distraction (cut-off 4.0 mm) were significant independent risk factors for early-onset ASD. Patients with preoperative imaging findings of bone marrow edema at the cranial segment had a 57.1% rate of early-onset ASD. A vacuum phenomenon and/or concomitant decompression at the cranial segment, the degree of surgical reduction of slippage, and lumbosacral spinal alignment were not risk factors for early-onset ASD. The need for fusion surgery requires careful consideration if vertebral bone marrow edema at the cranial segment adjacent to the fusion segment is detected on preoperative MRI, due to the negative impact of this edema on the incidence of early-onset ASD.

PMID:38644389 | PMC:PMC11033273 | DOI:10.1038/s41598-024-59924-5

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Risk factors for early-onset adjacent segment degeneration after one-segment posterior lumbar interbody fusion

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Sci Rep. 2024 Apr 21;14(1):9145. doi: 10.1038/s41598-024-59924-5. ABSTRACT Adjacent segment degeneration (ASD) is a major postoperative complication associated with posterior lumbar interbody fusion (PLIF). Early-onset ASD may differ pathologically from late-onset ASD. The aim of this study was to identify risk factors for early-onset ASD at the cranial segment occurring within 2 years after surgery.

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