Türk Nöroşirürji Dergisi 2015 , Vol 25 , Num 1
Adjacent Segment Disease Developing After Lumbar Fusion Surgery with the Transpedicular Fixation Technique and the Clinical Results
Rasim BABAYEV1, Serdar ÖZGEN2, Murat Şakir EKŞİ3, Deniz KONYA4
1Milli Onkoloji Merkezi, Nöroşirürji Anabilim Dalı, Bakü, Azerbaycan
2Acıbadem Üniversitesi, Tıp Fakültesi, Nöroşirürji Anabilim Dalı, İstanbul, Türkiye
3Kaliforniya Üniversitesi, San Francisco, Ortopedi Anabilim Dalı-Omurga Cerrahisi Merkezi, Kaliforniya, A.B.D.
4Bahçeşehir Üniversitesi, Tıp Fakültesi, Nöroşirürji Anabilim Dalı, İstanbul, Türkiye
AIM: We aimed to evaluate incidence of and related risk factors for adjacent segment degeneration occurring during the long-term follow-up of patients operated via posterior spinal fusion with the transpedicular fixation technique.

MATERIAL and METHODS: Patients with lumbar spinal stenosis due to a degenerative process were included in the study. There were 22 males and 84 females for a total of 106 patients. The patients were subdivided into 4 groups according to the fusion level. Back pain, leg pain, pain with movement, pain at rest, knee pain and hip pain were evaluated with VAS. Age, sex, BMI, fusion level, degree of lordosis after the operation, follow-up duration and smoking were predefined risk factors. Instability, disc herniation, disc bulging, spinal stenosis and disc degeneration were evaluated.

RESULTS: Disc bulging was the only significant mechanism for adjacent segment degeneration. Fusion surgery was a significant determinant for VAS scores. Age, BMI and fusion level were eff ective on the development of adjacent segment disease. There was a significant diff erence between one-level fusion and two-level fusion groups for adjacent segment degeneration development.

CONCLUSION: The lordosis angle showed no diff erence for one or two level fusions and a minimal diff erence with three or more level fusions. At the end of 2.8 years’ follow-up, the incidence of intervertebral disc bulging was higher than for the other factors. Anahtar Kelimeler : Lumbar fusion, Transpedicle fixation, Failed-back surgery syndrome, Adjacent segment degeneration, Adjacent segment disease