Adjacent segment disease after minimally invasive transforaminal lumbar interbody fusion for degenerative lumbar diseases: incidence and risk factors

作者全名："Yuan, Chao; Zhou, Jing; Wang, Liran; Deng, Zhongliang"

作者地址："[Yuan, Chao; Deng, Zhongliang] Chongqing Med Univ, Affiliated Hosp 2, Dept Orthopaed, 76 Linjiang Rd, Chongqing 400010, Peoples R China; [Zhou, Jing; Wang, Liran] Army Med Univ, Affiliated Xinqiao Hosp, Dept Orthopaed Surg, 183 Xingiao St, Chongqing 183, Peoples R China"

通信作者："Deng, ZL (通讯作者)，Chongqing Med Univ, Affiliated Hosp 2, Dept Orthopaed, 76 Linjiang Rd, Chongqing 400010, Peoples R China."

来源：BMC MUSCULOSKELETAL DISORDERS

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:000883421500001

JCR分区：Q2

影响因子：2.3

年份：2022

卷号：23

期号：1

开始页：　

结束页：　

文献类型：Article

关键词：Adjacent segment disease; Minimally invasive transforaminal lumbar interbody fusion; Degenerative lumbar diseases; Risk factors

摘要："Study design Retrospective study. Objectives To explore the incidence and risk factors for symptomatic adjacent segment disease (ASD) in patients enveloped in degenerative lumbar diseases after minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF). Methods Data were retrospectively analyzed on 744 patients who underwent MIS-TLIF for degenerative lumbar diseases in our hospital from October 2012 to December 2018. The patients were divided into the ASD group and non-ASD (N-ASD) group on the basis of developing ASD at follow-up, and then the incidence of ASD was calculated. Clinical and radiological risk factors were assessed over time to determine their association with ASD by excluding less important factors. Results Data were missing for 26 patients, while a total of 718 patients were successfully monitored after MIS-TLIF. Of the 718 individuals participated in the study, 34 (4.7%) patients plagued by ASD required surgical intervention. The average onset time of ASD was 62.7 +/- 15.1 months. Univariate analysis results shows that age, bone mineral density (BMD), body mass index (BMI), preoperative adjacent intervertebral disc height and preoperative adjacent segment disc degeneration were significantly different between the ASD and N-ASD groups (p < 0.05). The logistic regression analysis results demonstrated that BMD (p = 0.039, OR = 0.986, 95% CI 0.899-1.115), BMI (p = 0.041, OR = 1.119, 95% CI 1.103-2.397), and preoperative adjacent intervertebral disc degeneration (p = 0.023, OR = 1.215, 95% CI 1.015-1.986) may be seen as risk factors for ASD after MIS-TLIF. Conclusions The incidence of ASD was about 4.7% in patients suffer from degenerative lumbar diseases after MIS-TLIF. BMD, BMI and preoperative adjacent intervertebral disc degeneration might be the risk factors for the occurrence of ASD after MIS-TLIF. Our research also suggested that patients with lower BMD, higher BMI and disc preoperative adjacent segment disc degeneration were more likely to develop ASD after MIS-TLIF."

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