Select a Community
Are you sure you want to trigger topic in your Anconeus AI algorithm?
You are done for today with this topic.
Would you like to start learning session with this topic items scheduled for future?
less than 1%
1%
13/1843
1-10%
18%
334/1843
11-20%
28%
521/1843
21-30%
40%
728/1843
31-40%
12%
224/1843
Select Answer to see Preferred Response
The patient underwent lumbar decompression and posterolateral fusion with instrumentation. At 10 years roughly 36.1% require additional surgery (either decompression or decompression and fusion) at the adjacent level. Lumbar fusion is the mainstay of treatment for spinal stenosis with spondylolisthesis. Fusion in the lumbar spine can accelerate degeneration at adjacent cranial and caudad segments. A combination of increased mechanical stresses, altered regional alignment, and genetic factors contributes to breakdown. In many cases, the presence of radiographic degeneration may not be associated with symptoms. For those who do require surgery, laminectomy alone or combined with fusion may be necessary depending on presentation. More novel techniques, such as lateral interbody fusion, can often be used to address adjacent level pathology Ghiselli et al. retrospectively evaluated 215 patients who underwent posterior lumbar spine arthrodesis. They found that the rate of symptomatic degeneration requiring further fusion or decompression was 16.5% at 5 years and 36.1% at 10 years. Lee et al. retrospectively studied over 1000 patients undergoing lumbar fusion to determine risk factors for adjacent segment degeneration (ASD). Pre-existing facet degeneration was a strong risk factor and ASD occurs more frequently at the cranial segment than caudad segment. Figure A is a lumbar spine radiograph showing a lumbar posterolateral fusion with pedicle screw instrumentation. Incorrect Answers: Answers 1-4: At 10 years, roughly 36.1% of patients require further surgery adjacent to a fusion segment.
1.0
(7)
Please Login to add comment