Study On The Correlation Between Adjacent Segment Degeneration And The Number Of Lumbar Fusion Segments After Lumbar Fusion Surgery

Objective: The correlation between adjacent segment degeneration(ASD)and the number of lumbar fusion segments after lumbar fusion was studied by retrospective follow-up of patients who underwent lumbar fusion surgery due to lumbar degeneration.Methods: From January 1,2018 to December 30,2020,90 patients with lumbar diseases who underwent lumbar fusion surgery due to lumbar d egeneration in the People ’s Hospital of Guangxi Zhuang Autonomous Region were selected and divided into three groups according to the number of different fusion segments,with 30 cases in each group.The single-segment group was group A,the double-segment group was group B,and the three-segment group was group C.The basic information(age,gender,BMI,etc.),intervertebral space height,intervertebral space angle,Cobb angle,and intervertebral slip distance of the three groups were collected respect ively.The X-ray,CT and MRI of the lumbar spine were taken before and at the last follow-up.According to the imaging results at the last follow-up,the incidence of ASD was obtained by using the existing imaging evaluation criteria,and the relationship between the number of different fusion segments and the occurrence of postoperative ASD was analyzed.Results: The average follow-up time was 2.9 years,the age was 33-84 years,the average was 58.07 years.At the last follow-up,25 patients(28%)had adja cent segment degeneration,including 3 patients in Group A,9 patients in Group B,and13 patients in Group C.The incidence of ASD after lumbar fusion was correlated with the number of fusion segments(P< 0.05).It can be considered that the incidence of ASD increas es with the increase of the number of fusion segments.There was no statistically significant difference between Group A and Group B(P>0.05),and there was no statistically significant difference between Group B and Group C(P>0.05),while there was stati stically significant difference between Group A and Group C(P<0.05).Conclusion: The length of fusion segment is the influencing factor of adjacent segment degeneration after lumbar fusion.The incidence of adjacent segment degeneration(ASD)after lumb ar fusion increases with the increase of the number of fusion segments.Therefore,long-segment fixation should be avoided as much as possible,the responsible vertebral body should be accurately located,and the appropriate fusion segment shoul d be select ed.