A modified method to treat severe asymptomatic pre‐existing degeneration of adjacent segment: a retrospective case‐control study
BACKGROUND: Pre-existing degeneration of adjacent segment is an important risk factor for adjacent-segment degeneration (ASD), but only limited and controversial studies have addressed its management. METHODS: We retrospectively analyzed patients with symptomatic degeneration of the L5/S1 segment wa...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BioMed Central
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7989102/ https://www.ncbi.nlm.nih.gov/pubmed/33757478 http://dx.doi.org/10.1186/s12893-021-01163-w |
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author | Zhang, Xinliang Zhu, Jinwen Li, Yibing Hao, Dingjun Gao, Wenjie |
author_facet | Zhang, Xinliang Zhu, Jinwen Li, Yibing Hao, Dingjun Gao, Wenjie |
author_sort | Zhang, Xinliang |
collection | PubMed |
description | BACKGROUND: Pre-existing degeneration of adjacent segment is an important risk factor for adjacent-segment degeneration (ASD), but only limited and controversial studies have addressed its management. METHODS: We retrospectively analyzed patients with symptomatic degeneration of the L5/S1 segment warranting surgical interference and severe asymptomatic degeneration of the L4/5 segment. Of these patients, those who underwent interbody fusion of the causative (L5/S1) segment and distraction of the intervertebral space and facet fusion of the adjacent L4/5 segment were included in Group A (n = 103), while those who underwent interbody fusion of both the L5/S1 and L4/5 segments were included in Group B (n = 81). Clinical and radiographic outcomes were evaluated. RESULTS: Mean follow-up time was 58.5 months (range, 48–75 months). We found no significant difference in clinical outcomes or incidence of ASD in the L3/4 segment between Groups A and B. Compared with Group B, Group A experienced less bleeding (315 ± 84 ml vs. 532 ± 105 ml), shorter operation time (107 ± 34 min vs. 158 ± 55 min) and lower costs (US $13,830 ± $2640 vs. US $16,020 ± $3380; P < 0.05). In Group A, the disc height ratio (DHR) of the L4/5 segment was significantly increased from a preoperative value of 0.40 ± 0.13 to a last–follow-up value of 0.53 ± 0.18 (P < 0.05), while the degree of canal stenosis (DCS) was decreased from a preoperative value of 34.3 ± 11.2% to a last–follow-up value of 15.9 ± 9.3 % (P < 0.05). CONCLUSIONS: This modified method could be effective in treating severe asymptomatic pre-existing degeneration of adjacent segment in the lumbar spine. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12893-021-01163-w. |
format | Online Article Text |
id | pubmed-7989102 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-79891022021-03-25 A modified method to treat severe asymptomatic pre‐existing degeneration of adjacent segment: a retrospective case‐control study Zhang, Xinliang Zhu, Jinwen Li, Yibing Hao, Dingjun Gao, Wenjie BMC Surg Research Article BACKGROUND: Pre-existing degeneration of adjacent segment is an important risk factor for adjacent-segment degeneration (ASD), but only limited and controversial studies have addressed its management. METHODS: We retrospectively analyzed patients with symptomatic degeneration of the L5/S1 segment warranting surgical interference and severe asymptomatic degeneration of the L4/5 segment. Of these patients, those who underwent interbody fusion of the causative (L5/S1) segment and distraction of the intervertebral space and facet fusion of the adjacent L4/5 segment were included in Group A (n = 103), while those who underwent interbody fusion of both the L5/S1 and L4/5 segments were included in Group B (n = 81). Clinical and radiographic outcomes were evaluated. RESULTS: Mean follow-up time was 58.5 months (range, 48–75 months). We found no significant difference in clinical outcomes or incidence of ASD in the L3/4 segment between Groups A and B. Compared with Group B, Group A experienced less bleeding (315 ± 84 ml vs. 532 ± 105 ml), shorter operation time (107 ± 34 min vs. 158 ± 55 min) and lower costs (US $13,830 ± $2640 vs. US $16,020 ± $3380; P < 0.05). In Group A, the disc height ratio (DHR) of the L4/5 segment was significantly increased from a preoperative value of 0.40 ± 0.13 to a last–follow-up value of 0.53 ± 0.18 (P < 0.05), while the degree of canal stenosis (DCS) was decreased from a preoperative value of 34.3 ± 11.2% to a last–follow-up value of 15.9 ± 9.3 % (P < 0.05). CONCLUSIONS: This modified method could be effective in treating severe asymptomatic pre-existing degeneration of adjacent segment in the lumbar spine. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12893-021-01163-w. BioMed Central 2021-03-23 /pmc/articles/PMC7989102/ /pubmed/33757478 http://dx.doi.org/10.1186/s12893-021-01163-w Text en © The Author(s) 2021 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Article Zhang, Xinliang Zhu, Jinwen Li, Yibing Hao, Dingjun Gao, Wenjie A modified method to treat severe asymptomatic pre‐existing degeneration of adjacent segment: a retrospective case‐control study |
title | A modified method to treat severe asymptomatic pre‐existing degeneration of adjacent segment: a retrospective case‐control study |
title_full | A modified method to treat severe asymptomatic pre‐existing degeneration of adjacent segment: a retrospective case‐control study |
title_fullStr | A modified method to treat severe asymptomatic pre‐existing degeneration of adjacent segment: a retrospective case‐control study |
title_full_unstemmed | A modified method to treat severe asymptomatic pre‐existing degeneration of adjacent segment: a retrospective case‐control study |
title_short | A modified method to treat severe asymptomatic pre‐existing degeneration of adjacent segment: a retrospective case‐control study |
title_sort | modified method to treat severe asymptomatic pre‐existing degeneration of adjacent segment: a retrospective case‐control study |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7989102/ https://www.ncbi.nlm.nih.gov/pubmed/33757478 http://dx.doi.org/10.1186/s12893-021-01163-w |
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