Incidence of Adjacent Segment Disease Requiring Reoperation After Lumbar Laminectomy Without Fusion: A Study of 398 Patients

Neurosurgery
Mohamad BydonAli Bydon

Abstract

Adjacent segment disease (ASD) has not been described after laminectomy without fusion. To determine the incidence of ASD after a 1- or 2-level lumbar laminectomy. We retrospectively reviewed medical records of all patients who underwent 1- or 2-level, bilateral lumbar laminectomy without fusion for degenerative spinal disease (all follow-up ≥1 year). ASD was defined as clinical and/or radiographic evidence of degenerative spinal disease that required reoperation at the level above or below the index laminectomy. Of the 398 patients, the incidence of ASD requiring reoperation was 10%. The 39 ASD cases were almost equally distributed at L2-L3 (31%), L3-L4 (26%), and L5-S1 (31%), and to a lesser extent at L4-L5 (15%) (P = .51). The ASD incidences of 10% and 9% were equivalent after a 1- and 2-level laminectomy, respectively (P = .76). Rostral ASD was statistically more common than caudal ASD after both the 1- (P < .001) and 2- (P < .001) level laminectomy. Of the 39 ASD cases, 95% required laminectomy, 26% discectomy, and 49% fusion. Average time to ASD was 4 years. After a Kaplan-Meier analysis, time to reoperation for ASD was equivalent among the 1- and 2-level laminectomy cohorts (log-rank test, P = .13). The cumulative incide...Continue Reading

References

Nov 16, 2004·The Spine Journal : Official Journal of the North American Spine Society·Alan S Hilibrand, Matthew Robbins
Mar 20, 2012·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·Arno BisschopJaap H van Dieën

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Citations

Jun 9, 2016·Surgical Neurology International·Nancy Ellen Epstein
Sep 20, 2016·Clinical Spine Surgery : a Spine Publication·Daniel G TobertChristopher M Bono
Dec 3, 2016·Clinical Spine Surgery : a Spine Publication·Kee-Yong HaIn-Soo Oh
Nov 25, 2018·International Orthopaedics·Ko HashimotoEiji Itoi

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