COX Regression Analysis Of Risk Factors Of Adjacent Segment Deterioration Atfer Lumbar Fusion

Objective: To investigate the risk factors and the relative degree of postoperativeoccurrence of adjacent segment deterioration (ASDet) after lumbar fusion. To reduce theoccurrence of ASDet, improve the clinical efficacy of surgical treatment of lumbar fusionoperation.Methods:150cases were selected and followed-up through correspondence andout-patient department from the patients who underwent lumbar fusion operation duringSeptember2009to March2012, the maximum of follow-up time is40months and theminimum is10months, and136patients were included in the study. COX proportionalhazards regression model was used to analyze the correlation and the relative risk degreefrom the occurrence of ASDet and9related factors which included age, sex, osteoporosis,intervertebral disc degeneration, laminectomy, range of lumbar fusion, intervertebral discspace distraction, with/without internal fixation, lumbosacral fusion.Result: Multivariate COX regression analysis showed that intervertebral discdegeneration (RR=4.272，P=0.000) and intervertebral disc space distraction (RR=2.022，P=0.024) were significant correlated with the occurrence of adjacent segment deterioration.Conclusion: To choose operation reasonably for the patients with intervertebral discdegeneration and not to distract the intervertebral disc space overmuch could reduce theoccurrence of ASDet and to improve the clinical efficacy of surgical treatment of lumbarfusion operation.