Etiology-Based Classification of Adjacent Segment Disease Following Lumbar Spine Fusion.

HSS Journal : the Musculoskeletal Journal of Hospital for Special Surgery
Philip K LouieHoward S An

Abstract

Adjacent segment disease (ASDz) is a potential complication following lumbar spinal fusion. A common nomenclature based on etiology and ASDz type does not exist and is needed to assist with clinical prognostication, decision making, and management. The objective of this study was to develop an etiology-based classification system for ASDz following lumbar fusion. We conducted a retrospective chart review of 65 consecutive patients who had undergone both a lumbar fusion performed by a single surgeon and a subsequent procedure for ASDz. We established an etiology-based classification system for lumbar ASDz with the following six categories: "degenerative" (degenerative disc disease or spondylosis), "neurologic" (disc herniation, stenosis), "instability" (spondylolisthesis, rotatory subluxation), "deformity" (scoliosis, kyphosis), "complex" (fracture, infection), or "combined." Based on this scheme, we determined the rate of ASDz in each etiologic category. Of the 65 patients, 27 (41.5%) underwent surgery for neurogenic claudication or radiculopathy for adjacent-level stenosis or disc herniation and were classified as "neurologic." Ten patients (15.4%) had progressive degenerative disc pathology at the adjacent level and were clas...Continue Reading

References

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Citations

Jan 28, 2022·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Alexander L HornungDino Samartzis

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Methods Mentioned

BETA
X-ray

Software Mentioned

ASDeg
Stata
ASDz

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