Risk factors of radiological adjacent disc degeneration with lumbar interbody fusion for degenerative spondylolisthesis

Takashi Tsuji, Kota Watanabe, Naobumi Hosogane, Nobuyuki Fujita, Ken Ishii, Kazuhiro Chiba, Yoshiaki Toyama, Masaya Nakamura, Morio Matsumoto

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Background Although various risk factors have been reported for adjacent segment degeneration after lumbar fusion, the exact mechanisms and risk factors related to adjacent segment degeneration have not been clear. The present study was conducted to evaluate the risk factors for radiological adjacent segment degeneration in patients surgically treated for single-level L4 spondylolisthesis focusing on a single pathology, a specific fusion level, at a set interval. Methods We assessed preoperative and five-year postoperative radiographs for 72 patients who underwent L4-5 anterior or posterior lumbar interbody fusion for single-level L4 degenerative spondylolisthesis. Adjacent segment degeneration was defined as imaging evidence of one or more of the following conditions at L1-2, L2-3, or L3-4: 1) a loss of more than 20% of the preoperative disc height, 2) anterolisthesis or retrolisthesis greater than 3 mm, 3) or osteophyte formation greater than 3 mm. Results We found adjacent segment degeneration in 21 patients, with 31 discs affected. Multiple logistic regression analysis identified the following significant independent risk factors for adjacent segment degeneration: female gender (odds ratio 10.80; 95% confidence interval 1.20–96.89), posterior lumbar interbody fusion (odds ratio 7.70; 95% confidence interval 1.82–32.66), and pre-existing disc degeneration (odds ratio 12.29; 95% confidence interval 1.69–89.27). Conclusions Female gender, posterior lumbar interbody fusion, and pre-existing disc degeneration were significant independent risk factors for radiologically diagnosed adjacent segment degeneration in patients treated for L4 degenerative spondylolisthesis by interbody lumbar fusion.

Original languageEnglish
Pages (from-to)133-137
Number of pages5
JournalJournal of Orthopaedic Science
Volume21
Issue number2
DOIs
Publication statusPublished - 01-03-2016
Externally publishedYes

Fingerprint

Intervertebral Disc Degeneration
Spondylolisthesis
Odds Ratio
Confidence Intervals
Osteophyte
Logistic Models
Regression Analysis
Pathology

All Science Journal Classification (ASJC) codes

  • Orthopedics and Sports Medicine

Cite this

Tsuji, Takashi ; Watanabe, Kota ; Hosogane, Naobumi ; Fujita, Nobuyuki ; Ishii, Ken ; Chiba, Kazuhiro ; Toyama, Yoshiaki ; Nakamura, Masaya ; Matsumoto, Morio. / Risk factors of radiological adjacent disc degeneration with lumbar interbody fusion for degenerative spondylolisthesis. In: Journal of Orthopaedic Science. 2016 ; Vol. 21, No. 2. pp. 133-137.
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title = "Risk factors of radiological adjacent disc degeneration with lumbar interbody fusion for degenerative spondylolisthesis",
abstract = "Background Although various risk factors have been reported for adjacent segment degeneration after lumbar fusion, the exact mechanisms and risk factors related to adjacent segment degeneration have not been clear. The present study was conducted to evaluate the risk factors for radiological adjacent segment degeneration in patients surgically treated for single-level L4 spondylolisthesis focusing on a single pathology, a specific fusion level, at a set interval. Methods We assessed preoperative and five-year postoperative radiographs for 72 patients who underwent L4-5 anterior or posterior lumbar interbody fusion for single-level L4 degenerative spondylolisthesis. Adjacent segment degeneration was defined as imaging evidence of one or more of the following conditions at L1-2, L2-3, or L3-4: 1) a loss of more than 20{\%} of the preoperative disc height, 2) anterolisthesis or retrolisthesis greater than 3 mm, 3) or osteophyte formation greater than 3 mm. Results We found adjacent segment degeneration in 21 patients, with 31 discs affected. Multiple logistic regression analysis identified the following significant independent risk factors for adjacent segment degeneration: female gender (odds ratio 10.80; 95{\%} confidence interval 1.20–96.89), posterior lumbar interbody fusion (odds ratio 7.70; 95{\%} confidence interval 1.82–32.66), and pre-existing disc degeneration (odds ratio 12.29; 95{\%} confidence interval 1.69–89.27). Conclusions Female gender, posterior lumbar interbody fusion, and pre-existing disc degeneration were significant independent risk factors for radiologically diagnosed adjacent segment degeneration in patients treated for L4 degenerative spondylolisthesis by interbody lumbar fusion.",
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Tsuji, T, Watanabe, K, Hosogane, N, Fujita, N, Ishii, K, Chiba, K, Toyama, Y, Nakamura, M & Matsumoto, M 2016, 'Risk factors of radiological adjacent disc degeneration with lumbar interbody fusion for degenerative spondylolisthesis', Journal of Orthopaedic Science, vol. 21, no. 2, pp. 133-137. https://doi.org/10.1016/j.jos.2015.12.007

Risk factors of radiological adjacent disc degeneration with lumbar interbody fusion for degenerative spondylolisthesis. / Tsuji, Takashi; Watanabe, Kota; Hosogane, Naobumi; Fujita, Nobuyuki; Ishii, Ken; Chiba, Kazuhiro; Toyama, Yoshiaki; Nakamura, Masaya; Matsumoto, Morio.

In: Journal of Orthopaedic Science, Vol. 21, No. 2, 01.03.2016, p. 133-137.

Research output: Contribution to journalArticle

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T1 - Risk factors of radiological adjacent disc degeneration with lumbar interbody fusion for degenerative spondylolisthesis

AU - Tsuji, Takashi

AU - Watanabe, Kota

AU - Hosogane, Naobumi

AU - Fujita, Nobuyuki

AU - Ishii, Ken

AU - Chiba, Kazuhiro

AU - Toyama, Yoshiaki

AU - Nakamura, Masaya

AU - Matsumoto, Morio

PY - 2016/3/1

Y1 - 2016/3/1

N2 - Background Although various risk factors have been reported for adjacent segment degeneration after lumbar fusion, the exact mechanisms and risk factors related to adjacent segment degeneration have not been clear. The present study was conducted to evaluate the risk factors for radiological adjacent segment degeneration in patients surgically treated for single-level L4 spondylolisthesis focusing on a single pathology, a specific fusion level, at a set interval. Methods We assessed preoperative and five-year postoperative radiographs for 72 patients who underwent L4-5 anterior or posterior lumbar interbody fusion for single-level L4 degenerative spondylolisthesis. Adjacent segment degeneration was defined as imaging evidence of one or more of the following conditions at L1-2, L2-3, or L3-4: 1) a loss of more than 20% of the preoperative disc height, 2) anterolisthesis or retrolisthesis greater than 3 mm, 3) or osteophyte formation greater than 3 mm. Results We found adjacent segment degeneration in 21 patients, with 31 discs affected. Multiple logistic regression analysis identified the following significant independent risk factors for adjacent segment degeneration: female gender (odds ratio 10.80; 95% confidence interval 1.20–96.89), posterior lumbar interbody fusion (odds ratio 7.70; 95% confidence interval 1.82–32.66), and pre-existing disc degeneration (odds ratio 12.29; 95% confidence interval 1.69–89.27). Conclusions Female gender, posterior lumbar interbody fusion, and pre-existing disc degeneration were significant independent risk factors for radiologically diagnosed adjacent segment degeneration in patients treated for L4 degenerative spondylolisthesis by interbody lumbar fusion.

AB - Background Although various risk factors have been reported for adjacent segment degeneration after lumbar fusion, the exact mechanisms and risk factors related to adjacent segment degeneration have not been clear. The present study was conducted to evaluate the risk factors for radiological adjacent segment degeneration in patients surgically treated for single-level L4 spondylolisthesis focusing on a single pathology, a specific fusion level, at a set interval. Methods We assessed preoperative and five-year postoperative radiographs for 72 patients who underwent L4-5 anterior or posterior lumbar interbody fusion for single-level L4 degenerative spondylolisthesis. Adjacent segment degeneration was defined as imaging evidence of one or more of the following conditions at L1-2, L2-3, or L3-4: 1) a loss of more than 20% of the preoperative disc height, 2) anterolisthesis or retrolisthesis greater than 3 mm, 3) or osteophyte formation greater than 3 mm. Results We found adjacent segment degeneration in 21 patients, with 31 discs affected. Multiple logistic regression analysis identified the following significant independent risk factors for adjacent segment degeneration: female gender (odds ratio 10.80; 95% confidence interval 1.20–96.89), posterior lumbar interbody fusion (odds ratio 7.70; 95% confidence interval 1.82–32.66), and pre-existing disc degeneration (odds ratio 12.29; 95% confidence interval 1.69–89.27). Conclusions Female gender, posterior lumbar interbody fusion, and pre-existing disc degeneration were significant independent risk factors for radiologically diagnosed adjacent segment degeneration in patients treated for L4 degenerative spondylolisthesis by interbody lumbar fusion.

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