Clinical Results And Factors Affecting Adjacent Segment Degeneration After Lumbar Spinal Fusion

Objective: Spinal fusion has become a standard of care for numerous pathologicconditions of the human spine. But recently the adjacent segment degeneration(ASD)after spinal fusion is very common. Now we will investigate the clinical results andmake an assay of the factors affecting the nascence of adjacent segment degenerationafter posterior lumbar interbody fusion.Methods: A retrospective study of168patients who underwent the surgery ofposterior lumbar interbody fusion in The Second Dalian Medical University hospitalfrom January2008to July2011. There were96males and72females, the mean age is58.3years(range,35-81years).Observation on the clinical results of the surgery by JOAscore and work out the rate of adjacent segment degeneration through measuring theIntervertebral space height and other methods. Analyze the correlations of age, range offusion, position of fusion, peculiarity of the adjacent disc, working strength to theoccurrence of adjacent segment degeneration.Result: All the patients followed up17-60months (average,31.5months). All thepatients are satisfied with results of surgery. The incidence rate of ASD is17.86%in allthe patient. Peculiarity of the adjacent disc(P=0.02), age, intensity of labour are the highrisk factors. There is not enough evidence to prove that range of fusion and position offusion are the risk factors to the postoperative ASD.Conclusion: Posterior lumbar interbody fusion is a very important way to resolvethe question of low back. Senility, high intensity of work, presence of adjacent segmentdegeneration before the operation are associated with a obvious increased risk of ASD.