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학제간연구 과학기술학 뇌인지과학 기술정책 기타 복합학

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논문 기본 정보

자료유형
학술저널
저자정보
Kim, Jung-Ho (Department of Neurosurgery, College of Medicine, Inha University) Ryu, Dal-Sung (Department of Neurosurgery, College of Medicine, Inha University) Yoon, Seung-Hwan (Department of Neurosurgery, College of Medicine, Inha University)
저널정보
대한신경외과학회 대한신경외과학회지 대한신경외과학회지 제62권 제5호
발행연도
2019.1
수록면
603 - 609 (7page)

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Objective : The purpose of this retrospective study was to determine which of the proximal adjacent segment disease (ASD) and distal ASD was more prevalent and what parameters is more related to ASD in proximal levels and distal levels after more than 2 levels fusions. Methods : The medical records were reviewed retrospectively for 856 cases. A total of 66 cases of ASD were enrolled. On preop magnetic resonance imaging, disc degeneration was measured at the upper and lower parts of surgically treated levels and confirmed by the commonly used Pfirrmann grade. Segmental flexibility in sagittal plane was embodied in segment range of motion (ROM) obtained through flexion and extension X-ray before surgery. Coronal angle was recorded as methods Cobb's angle including fusion levels preoperatively. For the comparison of categorical variables between two independent groups, the chi-square test and Fisher exact test were performed. Results : Proximal ASD and distal ASD were 37/856 (4.32%) and 29/856 (3.39%), respectively. The incidence of proximal ASD was relatively high but insignificant differences. In comparison between ASD group and non ASD group, proximal Pfirmman was higher in proximal ASD and distal Pfirmman was higher in distal ASD group (p=0.005, p<0.008, respectively). However, in the ROM, proximal ROM was higher in proximal ASD, but distal ROM was not different between the two groups (p<0.0001, p=0.995, respectively). Coronal angle was not quite different in both groups (p=0.846). Conclusion : In spite of higher frequency in ASD in proximal level in spinal fusion, it is not clear that incidence of ASD in proximal level is not higher than that of distal ASD group in more than 2 level thoracolumbar fusions. Not only Pfirrmann grade but also proximal segmental ROM is risk factor for predicting the occurrence of ASD in patients more than 2 level of thoracolumbar spine fusion operation excluding L5S1.
#Pfirrmann #Intervertebral disc degeneration #Range of motion, Articular #Segment flexibility #Adjacent segment disease #Radiographical ASD

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참고문헌 (15)

참고문헌 신청
Sang-Soak Ahn / 2016 / Radiologic Findings and Risk Factors of Adjacent Segment Degeneration after Anterior Cervical Discectomy and Fusion : A Retrospective Matched Cohort Study with 3-Year Follow-Up Using MRI / 대한신경외과학회지 59(2):129~136 google schola Anandjiwala J / 2011 / Adjacent segment degeneration after instrumented posterolateral lumbar fusion: a prospective cohort study with a minimum five-year follow-up / Eur Spine J 20:1951~1960 google schola Axelsson P / 1994 / Posterolateral lumbar fusion. Outcome of 71 consecutive operations after 4(2-7)years / Acta Orthop Scand 65:309~314 google schola Bisschop A / 2015 / The effects of single-level instrumented lumbar laminectomy on adjacent spinal biomechanics / Global Spine J 5:39~48 google schola Chen WJ / 2001 / Surgical treatment of adjacent instability after lumbar spine fusion / Spine (Phila Pa 1976) 26:E519~E524 google schola

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