Adjacent Segment Degeneration (ASD) Following Lumber Arthrodesis; Risk Factors and Management.

Background Data: Spinal bony fusion is considered to be a good method for treating deformity, trauma, and degenerative lesions. Fusion rates have a good outcome due to improvements in instrumented fixation and bone graft sources. In contrast, numerous complications of fusion surgery may occur and ar...

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Autor principal: Mohammed Eshra
Formato: article
Lenguaje:EN
Publicado: Egyptian Spine Association 2013
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Acceso en línea:https://doaj.org/article/7fdb8f98ccb244288acaf5fc106f0dd5
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spelling oai:doaj.org-article:7fdb8f98ccb244288acaf5fc106f0dd52021-12-02T00:30:32ZAdjacent Segment Degeneration (ASD) Following Lumber Arthrodesis; Risk Factors and Management.DOI:10.21608/ESJ.2013.38092314-89502314-8969https://doaj.org/article/7fdb8f98ccb244288acaf5fc106f0dd52013-01-01T00:00:00Zhttp://esj.journals.ekb.eg/article_3809.htmlhttps://doaj.org/toc/2314-8950https://doaj.org/toc/2314-8969Background Data: Spinal bony fusion is considered to be a good method for treating deformity, trauma, and degenerative lesions. Fusion rates have a good outcome due to improvements in instrumented fixation and bone graft sources. In contrast, numerous complications of fusion surgery may occur and are considered as the predisposing factors for clinical failure after instrumented lumbar fusion. Adjacent segment disease after lumbar spine fusion has been found to occur nowadays with a variable incidence. The risk factors for ASD have not been precisely documented. Purpose: To identify the possible risk factors responsible for adjacent segment affection following lumbosacral fixation and review the literature about their most suitable management. Study Design: A retrospective descriptive clinical case study. Patients and Methods: seventeen patients with lumbosacral fixation for spondylolisthesis or disc degeneration were identified to have de novo adjacent segment degeneration one to four years following fusion surgery. They were studied as regard age, primary pathology, number of levels and type of fusion and the duration of the lucid interval between the primary surgery and the revision management. Patients were studied radiologically by whole imaging techniques. They were followed up both clinically and radiologically for at least one and half years after revision management. Results: the risk factors include fixation of more than one level, overweight and preexisting facet degeneration in the adjacent segment. The incidence of distal ASD was much lower than that of proximal ASD. Conclusion: longer periods of follow up are needed to determine which of the accused risk factors are responsible for increasing the incidence of ASD and until solid conclusions are established, we should try to minimize the number of risk factors. (2013ESJ037 Mohammed EshraEgyptian Spine Associationarticlelumber spinearthrodesisdisc degenerationadjacent segment diseaseNeurology. Diseases of the nervous systemRC346-429ENEgyptian Spine Journal, Vol 5, Iss 1, Pp 30-35 (2013)
institution DOAJ
collection DOAJ
language EN
topic lumber spine
arthrodesis
disc degeneration
adjacent segment disease
Neurology. Diseases of the nervous system
RC346-429
spellingShingle lumber spine
arthrodesis
disc degeneration
adjacent segment disease
Neurology. Diseases of the nervous system
RC346-429
Mohammed Eshra
Adjacent Segment Degeneration (ASD) Following Lumber Arthrodesis; Risk Factors and Management.
description Background Data: Spinal bony fusion is considered to be a good method for treating deformity, trauma, and degenerative lesions. Fusion rates have a good outcome due to improvements in instrumented fixation and bone graft sources. In contrast, numerous complications of fusion surgery may occur and are considered as the predisposing factors for clinical failure after instrumented lumbar fusion. Adjacent segment disease after lumbar spine fusion has been found to occur nowadays with a variable incidence. The risk factors for ASD have not been precisely documented. Purpose: To identify the possible risk factors responsible for adjacent segment affection following lumbosacral fixation and review the literature about their most suitable management. Study Design: A retrospective descriptive clinical case study. Patients and Methods: seventeen patients with lumbosacral fixation for spondylolisthesis or disc degeneration were identified to have de novo adjacent segment degeneration one to four years following fusion surgery. They were studied as regard age, primary pathology, number of levels and type of fusion and the duration of the lucid interval between the primary surgery and the revision management. Patients were studied radiologically by whole imaging techniques. They were followed up both clinically and radiologically for at least one and half years after revision management. Results: the risk factors include fixation of more than one level, overweight and preexisting facet degeneration in the adjacent segment. The incidence of distal ASD was much lower than that of proximal ASD. Conclusion: longer periods of follow up are needed to determine which of the accused risk factors are responsible for increasing the incidence of ASD and until solid conclusions are established, we should try to minimize the number of risk factors. (2013ESJ037
format article
author Mohammed Eshra
author_facet Mohammed Eshra
author_sort Mohammed Eshra
title Adjacent Segment Degeneration (ASD) Following Lumber Arthrodesis; Risk Factors and Management.
title_short Adjacent Segment Degeneration (ASD) Following Lumber Arthrodesis; Risk Factors and Management.
title_full Adjacent Segment Degeneration (ASD) Following Lumber Arthrodesis; Risk Factors and Management.
title_fullStr Adjacent Segment Degeneration (ASD) Following Lumber Arthrodesis; Risk Factors and Management.
title_full_unstemmed Adjacent Segment Degeneration (ASD) Following Lumber Arthrodesis; Risk Factors and Management.
title_sort adjacent segment degeneration (asd) following lumber arthrodesis; risk factors and management.
publisher Egyptian Spine Association
publishDate 2013
url https://doaj.org/article/7fdb8f98ccb244288acaf5fc106f0dd5
work_keys_str_mv AT mohammedeshra adjacentsegmentdegenerationasdfollowinglumberarthrodesisriskfactorsandmanagement
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