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학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
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연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
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Objective : Many biomechanical and clinical studies on adjacent segment degeneration (ASD) have addressed cranial segment. No study has been conducted on caudal segment degeneration after upper segment multiple lumbar fusions. This is a retrospective investigation of the L5-S1 segment after spinal fusion at and above L4-5, which was undertaken to analyze the rate of caudal ASD at L5-S1 after spinal fusion on and above L4-5 and to determine that factors that might have influenced it. Methods : The authors included 67 patients with L4-5, L3-5, or L2-5 posterior fusions. Among these patients, 28 underwent L4-5 fusion, 23 L3-5, and 16 L2-5 fusions. Pre- and postoperative radiographs were analyzed to assess degenerative changes at L5-S1. Also, clinical results after fusion surgery were analyzed. Results : Among the 67 patients, 3 had pseudoarthrosis, and 35 had no evidence of ASD, cranially and caudally. Thirteen patients (19.4%) showed caudal ASD, 23 (34.3%) cranial ASD, and 4 (6.0%) both cranial and caudal ASD. Correlation analysis for caudal ASD at L5-S1 showed that pre-existing L5-S1 degeneration was most strongly correlated. In addition, numbers of fusion segments and age were also found to be correlated. Clinical outcome was not correlated with caudal ASD at L5-S1. Conclusion : If caudal and cranial ASD are considered, the overall occurrence rate of ASD increases to 50%. The incidence rate of caudal ASD at L5-S1 was significantly lower than that of cranial ASD. Furthermore, the occurrence of caudal ASD was found to be significantly correlated with pre-existing disc degeneration.
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참고문헌 (15)
참고문헌 신청
Cochran T / 1983 / Long-term anatomic and functional changes in patients with adolescent idiopathic scoliosis treated by Harrington rod fusion / Spine 8:576~584
Cohn EL / 1997 / Plain film evaluation of degenerative disk disease at the lumbosacral junction / Skeletal Radiol 26:161~166
Frymoyer JW / 1978 / Disc excision and spine fusion in the management of lumbar disc disease. A minimum ten-year followup / Spine 3:1~6
Ghiselli G / 2004 / Adjacent segment degeneration in the lumbar spine / J Bone Joint Surg Am 86:1497~1503
Ghiselli G / 2003 / L5-S1 segment survivorship and clinical outcome analysis after L4-L5 isolated fusion / Spine 28:1275~1280
Cohn EL / 1997 / Plain film evaluation of degenerative disk disease at the lumbosacral junction / Skeletal Radiol 26:161~166
Frymoyer JW / 1978 / Disc excision and spine fusion in the management of lumbar disc disease. A minimum ten-year followup / Spine 3:1~6
Ghiselli G / 2004 / Adjacent segment degeneration in the lumbar spine / J Bone Joint Surg Am 86:1497~1503
Ghiselli G / 2003 / L5-S1 segment survivorship and clinical outcome analysis after L4-L5 isolated fusion / Spine 28:1275~1280
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