Influencing Factors Of Adjacent Segment Degeneration After Surgery With Lumbar Spinal Stenosis

Objective:The aim of the retrospective analysis study was to evaluate the factors of adjacent segment degeneration (ASD) with lumbar spinal stenosis after single segment lumbar decompression and fusion internal fixation.Methods:Collect the clinical data of164patients with single posterior lumbar decompression and fusion graft fixation for Lumbar spinal stenosis and evaluate adjacent segment degeneration by X-chip and postoperative symptoms. Age, surgical segment adjacent disc degeneration and other factors were analyzed by t test,chi-square test and logistic regression statistical methods.Resules:All patients were followed for34-70months Significant differences were found in adjacent segment disc degeneration age、lumbar lordosis of L4-S1between the group with ASD and without one by univariate analysis(P<0.05).Age, lumbar lordosis of L4-S1, preoperative adjacent disc degeneration were associated with ASD by logistic regression analysis(P<0.05).The probability of suffering from ASD of the patient with>65age after the fusion of the lumbar spine fixation is2.338times as hige as one with<65age; the probability of suffering from ASD of the patient with preoperative adjacent disc degeneration is2.181times as hige as one without preoperative adjacent disc degeneration; the probability of suffering from ASD of the patient whose lumbar lordosis of L4-S1is≥29°is0.313times as high as the patient whose lumbar lordosis of L4-S1is <29°.Conlusion:The age above65years、preoperative adjacent segment disc degeneration、lumbar lordosis of L4-S1in the29°are the risk factors of ASD Lumbar lordosis of the patient for≥65years and adjacent disc degeneration was reconstructed in surgery.Patients whose lumbar lordosis of L4-S1is lower29°should be wary of ASD and decrease posture that could cause the degeneration.