caa a22 4500 445835273 CHVBK 20180317145328.0 cr unu---uuuuu 170323e20111101xx s 000 0 eng 10.1007/s00586-011-1917-0 doi (NATIONALLICENCE)springer-10.1007/s00586-011-1917-0 Adjacent segment degeneration after instrumented posterolateral lumbar fusion: a prospective cohort study with a minimum five-year follow-up [Elektronische Daten] [Jigar Anandjiwala, Jun-Yeong Seo, Kee-Yong Ha, In-Soo Oh, Dong-Cheul Shin] Purpose: To (1) clarify the role of various risk factors in the development of ASD, (2) compare instrumentation configuration with the development of ASD, (3) correlate the radiological incidence of ASD and its clinical outcome and (4) compare the clinical outcome between patients with radiological evidence of ASD and without ASD. Methods: This study prospectively examined 74 consecutive patients who underwent instrumented lumbar/lumbosacral fusion for degenerative disease with a minimum follow-up of 5years. Among the patients, 68 were enrolled in the study. All of the patients had undergone preoperative radiological assessment and postoperative radiological assessment at regular intervals. The onset and progression of ASD changes were evaluated. The patients were divided in two groups: patients with radiographic evidence of ASD (group 1) and patients without ASD changes (group 2). Comprehensive analysis of various risk factors between group 1 and group 2 patients was performed. The Visual Analog Scale (VAS) was used to evaluate the clinical outcome and the functional outcome was evaluated using the Oswestry Disability Index (ODI) before and after surgery along with radiological assessment. Results: Radiographic ASD occurred in 20.6% (14/68) of patients. Preoperative disc degeneration at an adjacent segment was a significant risk factor for ASD. Other risk factors such as the age of a patient at the time of surgery, gender, preoperative diagnosis, length of fusion, instrumentation configuration, sagittal alignment and lumbar or lumbosacral fusion were not significant risk factors for the development of ASD. There was no correlation between ASD and its clinical outcome as determined at the final follow-up session. In addition, clinical outcome of patients with ASD and without ASD were not comparable. Conclusions: Patients with preoperative disc degeneration at an adjacent segment were more at risk for the development of ASD. Other risk factors including instrumentation configuration were not significantly associated with ASD. There was no correlation between both the radiological development of ASD and its clinical outcome and the clinical outcome of patients with and without ASD. Springer-Verlag, 2011 Adjacent segment degeneration nationallicence Instrumented lumbar fusion nationallicence Risk factors nationallicence Anandjiwala Jigar Department of Orthopedic Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 505 Banpo-Dong, Seocho-Ku, 137 040, Seoul, Korea aut Seo Jun-Yeong Department of Orthopedic Surgery, Jeju National University Hospital, School of Medicine, Jeju National University, Jeju, Korea aut Ha Kee-Yong Department of Orthopedic Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 505 Banpo-Dong, Seocho-Ku, 137 040, Seoul, Korea aut Oh In-Soo Department of Orthopedic Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 505 Banpo-Dong, Seocho-Ku, 137 040, Seoul, Korea aut Shin Dong-Cheul Department of Orthopedic Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 505 Banpo-Dong, Seocho-Ku, 137 040, Seoul, Korea aut European Spine Journal Springer-Verlag 20/11(2011-11-01), 1951-1960 0940-6719 20:11<1951 2011 20 586 https://doi.org/10.1007/s00586-011-1917-0 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00586-011-1917-0 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Anandjiwala Jigar Department of Orthopedic Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 505 Banpo-Dong, Seocho-Ku, 137 040, Seoul, Korea aut NATIONALLICENCE 700 1- Seo Jun-Yeong Department of Orthopedic Surgery, Jeju National University Hospital, School of Medicine, Jeju National University, Jeju, Korea aut NATIONALLICENCE 700 1- Ha Kee-Yong Department of Orthopedic Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 505 Banpo-Dong, Seocho-Ku, 137 040, Seoul, Korea aut NATIONALLICENCE 700 1- Oh In-Soo Department of Orthopedic Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 505 Banpo-Dong, Seocho-Ku, 137 040, Seoul, Korea aut NATIONALLICENCE 700 1- Shin Dong-Cheul Department of Orthopedic Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 505 Banpo-Dong, Seocho-Ku, 137 040, Seoul, Korea aut NATIONALLICENCE 773 0- European Spine Journal Springer-Verlag 20/11(2011-11-01), 1951-1960 0940-6719 20:11<1951 2011 20 586 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer