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http://dx.doi.org/10.3340/jkns.2015.57.2.108

Survival Rates and Risk Factors for Cephalad and L5-S1 Adjacent Segment Degeneration after L5 Floating Lumbar Fusion : A Minimum 2-Year Follow-Up  

Lee, Young-Seok (Department of Neurosurgery, Chung-Ang University College of Medicine)
Kim, Young-Baeg (Department of Neurosurgery, Chung-Ang University College of Medicine)
Park, Seung-Won (Department of Neurosurgery, Chung-Ang University College of Medicine)
Publication Information
Journal of Korean Neurosurgical Society / v.57, no.2, 2015 , pp. 108-113 More about this Journal
Abstract
Objective : Although the L5-S1 has distinct structural features in comparison with other lumbar spine segments, not much is known about adjacent segment degeneration (ASD) at the L5-S1 segment. The aim of study was to compare the incidence and character of ASD of the cephalad and L5-S1 segments after L5 floating lumbar fusion. Methods : From 2005 to 2010, 115 patients who underwent L5 floating lumber fusion were investigated. The mean follow-up period was 46.1 months. The incidence of radiological and clinical ASD of the cephalad and the L5-S1 segments was compared using survival analysis. Risk factors affecting ASD were analyzed using a log rank test and the Cox proportional hazard model. Results : Radiological ASD of the L5-S1 segment had a statistically significant higher survival rate than that of the cephalad segment (p=0.001). However, clinical ASD of the L5-S1 segment was significantly lower survival rates than that of the cephalad segment (p=0.038). Risk factor analysis showed that disc degeneration of the cephalad segment and preoperative spinal stenosis of the L5-S1 segment were risk factors. Conclusion : In L5 floating fusion, radiological ASD was more common in the cephalad segment and clinical ASD was more common in the L5-S1 segment. At the L5-S1 segment, the degree of spinal stenosis appears to be the most influential risk factor in ASD incidences, unlike the cephalad segment.
Keywords
Radiological adjacent segment degeneration; Clinical adjacent segment degeneration; Cephalad segment; L5-S1 segment;
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Times Cited By KSCI : 1  (Citation Analysis)
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