Artikel
Analysis of risk factors for postoperative progressive segment degeneration at the decompression and non-decompression segments after minimally invasive lumbar decompression surgery: A 5-year follow-up study
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Autoren
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Hasibullah Habibi
- Osaka Metropolitan University, Shimada Hospital, Orthopedic surgery department, Graduate school of medicine, Osaka, Japan
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Hiromitsu Toyoda
- Osaka Metropolitan University, Orthopedic surgery department, Graduate school of medicine, Osaka, Japan
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Hidetomi Terai
- Osaka Metropolitan University, Orthopedic surgery department, Graduate school of medicine, Osaka, Japan
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Hiroshi Katsuda
- Shimada Hospital, Osaka, Japan
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Nagakazu Shimada
- Shimada Hospital, Osaka, Japan
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Hiroaki Nakamura
- Osaka Metropolitan University, Orthopedic surgery department, Graduate school of medicine, Osaka, Japan
| Veröffentlicht: | 21. Oktober 2024 |
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Gliederung
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Objectives: The risk factors for the development of progressive segment degeneration (PSD) after decompression surgery remain unknown. This study aimed to investigate the risk factors for PSD in patients who undergo decompression surgery for lumbar spinal stenosis with and without coexisting spondylolisthesis and scoliosis, focusing on decompression and non-decompression segments.
Methods: We reviewed the data of patients with > 5 years of postoperative follow-up. Radiographic PSD was defined as either the development of an antero- or retrolisthesis of > 3 mm or a decrease in disc height of > 3 mm during the 5-year follow-up. The association between PSD and other preoperative clinical findings was analyzed according to intervertebral segments.
Results: Overall, 840 lumbar segments (L1-2 to L5-S) in 168 patients, with a mean age of 69.5 ± 9.2 years, met the inclusion criteria. PSD was observed in 162 (19.3%) lumbar segments. A logistic regression model identified that Cobb angle equal or >10° (OR 2.53, 95% CI 1.50–4.24), spondylolisthesis equal or >3 mm (OR 4.447, 95% CI 2.06–9.58), and level of segments were more likely to have PSD at the non-decompression level; in addition, lateral listhesis equal or >3 mm (OR 2.91, 95% CI 1.08–7.81) was more likely to have PSD in the decompression segments. There was no significant difference in clinical outcomes in patients with PSD at baseline and the 5-year follow-up.
Conclusion: Although PSD does not correlate with worsening symptoms, our study confirms that higher degree of pre-existing disc degeneration is indicative of a higher PSD in 5 years.
