| Title |
Risk factors for adjacent segment disease after lumbar fusion
|
|---|---|
| Published in |
European Spine Journal, June 2009
|
| DOI | 10.1007/s00586-009-1060-3 |
| Pubmed ID | |
| Authors |
Choon Sung Lee, Chang Ju Hwang, Sung-Woo Lee, Young-Joon Ahn, Yung-Tae Kim, Dong-Ho Lee, Mi Young Lee |
| Abstract |
The incidence of adjacent segment problems after lumbar fusion has been found to vary, and risk factors for these problems have not been precisely verified, especially based on structural changes determined by magnetic resonance imaging. The purpose of this retrospective clinical study was to describe the incidence and clinical features of adjacent segment disease (ASD) after lumbar fusion and to determine its risk factors. We assessed the incidence of ASD in patients who underwent lumbar or lumbosacral fusions for degenerative conditions between August 1995 and March 2006 with at least a 1-year follow-up. Patients less than 35 years of age at the index spinal fusion, patients with uninstrumented fusion, and patients who had not achieved successful union were excluded. Of the 1069 patients who underwent fusions, 28 (2.62%) needed secondary operations because of ASD and were included in this study. In order to identify the risk factors, we matched a disease group and a control group. The disease group consisted of 26 of the 28 patients with ASD, excluding the 2 patients for whom we did not have initial MRI data. Each patient in the disease group was matched by age, sex, fusion level and follow-up period with a control patient. The assumed risk factors included disc and facet degeneration, instability, listhesis, rotational deformity, and disc wedging. The mean age of the 28 patients with ASD requiring surgical treatment was 58.4 years, which did not differ significantly from that of the population in which ASD did not develop (58.2 years, p = 0.894). Of the 21 patients who underwent floating fusion, only 1 developed distal ASD. Facet degeneration was a significant risk factor (p < 0.01) on logistic regression analysis. The incidence of distal ASD was much lower than that of proximal ASD. Pre-existing facet degeneration may be associated with a high risk of adjacent segment problems following lumbar fusion procedures. |
Mendeley readers
The data shown below were compiled from readership statistics for 133 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United States | 4 | 3% |
| Turkey | 1 | <1% |
| Unknown | 128 | 96% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Researcher | 21 | 16% |
| Student > Ph. D. Student | 13 | 10% |
| Other | 11 | 8% |
| Student > Doctoral Student | 11 | 8% |
| Student > Master | 10 | 8% |
| Other | 34 | 26% |
| Unknown | 33 | 25% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 64 | 48% |
| Engineering | 12 | 9% |
| Neuroscience | 4 | 3% |
| Psychology | 3 | 2% |
| Agricultural and Biological Sciences | 2 | 2% |
| Other | 13 | 10% |
| Unknown | 35 | 26% |
Attention Score in Context
This research output has an Altmetric Attention Score of 7. 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 09 July 2014.
All research outputs
#4,165,350
of 22,758,248 outputs
Outputs from European Spine Journal
#439
of 4,613 outputs
Outputs of similar age
#15,695
of 98,602 outputs
Outputs of similar age from European Spine Journal
#3
of 23 outputs
Altmetric has tracked 22,758,248 research outputs across all sources so far. Compared to these this one has done well and is in the 80th percentile: it's in the top 25% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 4,613 research outputs from this source. They receive a mean Attention Score of 4.0. This one has done well, scoring higher than 89% of its peers.
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We're also able to compare this research output to 23 others from the same source and published within six weeks on either side of this one. This one has done well, scoring higher than 82% of its contemporaries.