Relationship between age or fusion choice and reoperation of adjacent segment disease after posterior lumbar fusion

English Keywords:Posterior lumbar fusion  Adjacent segment disease  Reoperation  Age  Methods of fusion

English Abstract:

  【Abstract】 Objectives: To explore the relationship between the age of patients or fusion choice and reoperation of adjacent segment disease(ASD) after posterior lumbar fusion. Methods: Clinical data of 339 patients who underwent posterior lumbar fusion between March 2007 and March 2017 were retrospectively analyzed. Reoperation group included 113 patients who received additional surgery for ASD and control group included 226 cases without ASD after the initial surgery. The original fusion choices for reoperation group were 67 of posterior lumbar interbody fusion(PLIF), 23 of posterior lumbar fusion(PLF) and 21 of transforaminal lumber interbody fusion(TLIF). For the control group, 97 received PLIF, 45 received PLF and 84 received TLIF. The clinical outcomes were evaluated by the comparison of VAS score and lumbar JOA score between preoperation and the last follow-up. Results: The mean age was 56.4±2.1 years in reoperation group and 57.1±1.1 years in control group, and the mean follow-up period was 24.6±1.1 months in reoperation group and 24.9±0.6 months in control group. The VAS scores of lumbar pain and lumbar JOA score at the last follow-up in both reoperation group and control group were significantly lower than those of preoperation. Reoperation group showed significantly lower VAS and lumbar JOA score at the last follow-up compared with control group. Additionally, patients who were 60 or older at the initial surgery were more likely to suffer from ASD, and patients who received PLF and TLIF were less likely to be affected by ASD. Conclusions: It is concluded that higher age at the initial surgery and PLIF is more likely to result in ASD and reoperation.