Relationship between adjacent segment degeneration and clinical outcome after lumbar spine fusion / 中国矫形外科杂志

ABSTRACT

[Objective] To determine the relationship between the adjacent segment degeneration(ASD)and the clinical outcome after lumbar spine fusion.[Methods]Totally 436 patients undergoing posterolateral lumbar fusion were followed up for 58.13 months(26~114 months).The patients were divided into 3 groups according to the number of the fusion segments1 segment,2 segments and 3 or more segments.UCLA grading scale was used to evaluate the degeneration of the adjacent segments.Cinical outcome was evaluated according to the criteria established by Hou SH.[Results]Adjacent segment degeneration(ASD)occurred in 58 patients,including 14 in group A,27 in group B and 17 in group C.Forty-nine patients had their ASD above the fusion level and 9 below the fusion level.For all the 14 patients in group A,the degenerative grade increased by 1 grade.Of the 27 patients in group B,16 increased by 1 grade,7 by 2 grades,and 4 by 3 grades.Of the 17 patients in group C,4 increased by 1 grade,8 by 2 grades and 5 by 3 grades.For the clinical outcome,7 patients in group A increased by 1 grade.In group B,13 patients increased by 2 grade and 5 patients increased by 3 grades.For the clinical effect degrees,7 cases decreased by 1 degree in group A.In group B,13 cases decreased by 1 degree and 6 decreased by 2 degrees.[Conclusion]No significant relationship was found between the adjacent segment degeneration and the clinical outcome.Careful attention is needed for avoidance of multi-segmental fusion.