| Title |
Disc height reduction in adjacent segments and clinical outcome 10 years after lumbar 360° fusion
|
|---|---|
| Published in |
European Spine Journal, October 2007
|
| DOI | 10.1007/s00586-007-0515-7 |
| Pubmed ID | |
| Authors |
Tobias L. Schulte, Freek Leistra, Viola Bullmann, Nani Osada, Volker Vieth, Björn Marquardt, Thomas Lerner, Ulf Liljenqvist, Lars Hackenberg |
| Abstract |
Adjacent segment degeneration (ASD) is discussed to impair long-term outcome after lumbar interbody fusion. Nevertheless the amount and origin of degeneration and its clinical relevance remain unclear. Only little data is published studying quantitative disc height reduction (DHR) as indicator for ASD in long-term follow-up. Forty patients (23 men, 17 women) (group 1: degenerative disc disease, n = 27; group 2: lytic spondylolisthesis, n = 13) underwent lumbar 360 degrees instrumentation and fusion between 1991 and 1997. Preoperative and follow-up lateral lumbar radiographs were studied. Disc heights of first and second cephalad adjacent segments were measured by Farfan's technique and Hurxthal's technique modified by Pope. Clinical outcome was studied using Oswestry disability index (ODI) and visual analogue scale (VAS). Age, gender, prior surgery, fusion rate and number of fusion levels were investigated as potential factors affecting the outcome. Mean follow-up was 114 (72-161) months. Clinical outcome showed an improvement of 44.6% in ODI and 43.8% in VAS with a tendency towards better results in group 2. Fusion rate was 95%. Disc height of the first cephalad adjacent segment in all patients was reduced by on average 21% (Farfan, P < 0.001) and 19% (Pope, P < 0.001), respectively, and that of the second adjacent level by on average 16% (Farfan, P < 0.001) and 14% (Pope, P < 0.001), respectively. A tendency towards more disc height reduction (DHR) in the degenerative group was observed. Advanced age correlated with advanced DHR (P < or = 0.003, r = 0.5). Multiple level fusion led to a more pronounced DHR than 1-level fusion (P = 0.028). There was a tendency towards more DHR in the first adjacent disc compared to the second. Gender, prior surgery of the fused segment and fusion level did not affect the amount of DHR. There was no correlation between the clinical outcome and DHR. Lumbar fusion is associated with DHR of adjacent discs. This may be induced by additional biomechanical stress, ongoing degeneration affecting the lumbar spine and advancing age. However, clinical outcome is not correlated with adjacent DHR. |
X Demographics
The data shown below were collected from the profile of 1 X user who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Spain | 1 | 100% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 1 | 100% |
Mendeley readers
The data shown below were compiled from readership statistics for 72 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Spain | 1 | 1% |
| United States | 1 | 1% |
| Brazil | 1 | 1% |
| Unknown | 69 | 96% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Researcher | 14 | 19% |
| Student > Master | 12 | 17% |
| Student > Ph. D. Student | 10 | 14% |
| Student > Postgraduate | 6 | 8% |
| Other | 6 | 8% |
| Other | 14 | 19% |
| Unknown | 10 | 14% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 35 | 49% |
| Engineering | 8 | 11% |
| Sports and Recreations | 3 | 4% |
| Agricultural and Biological Sciences | 3 | 4% |
| Nursing and Health Professions | 2 | 3% |
| Other | 4 | 6% |
| Unknown | 17 | 24% |
Attention Score in Context
This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 29 January 2017.
All research outputs
#18,525,776
of 22,947,506 outputs
Outputs from European Spine Journal
#2,497
of 4,657 outputs
Outputs of similar age
#66,930
of 72,354 outputs
Outputs of similar age from European Spine Journal
#18
of 20 outputs
Altmetric has tracked 22,947,506 research outputs across all sources so far. This one is in the 11th percentile – i.e., 11% of other outputs scored the same or lower than it.
So far Altmetric has tracked 4,657 research outputs from this source. They receive a mean Attention Score of 4.1. This one is in the 21st percentile – i.e., 21% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 72,354 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 3rd percentile – i.e., 3% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 20 others from the same source and published within six weeks on either side of this one. This one is in the 10th percentile – i.e., 10% of its contemporaries scored the same or lower than it.