PURPOSE: Aim of this study is to estimate the risk for symptomatic adjacent segment degeneration (ASD) and examine the association between spino-pelvic parameters and ASD. METHODS: 22 patients operated upon by instrumented lumbar or lumbosacral spinal fusion and re-operated upon for ASD were enrolled in the study. 83 consecutive patients with the same surgery and never re-operated upon were the controls. Pelvic incidence, sacral slope (SS), pelvic tilt (PT), and lumbar lordosis were calculated. RESULTS: Patients with ASD had significantly lower SS (p = 0.005) and higher PT values (p < 0.001). Patients with SS <39° or PT >21°, were at higher risk for symptomatic ASD (relative risk 1.73 for SS and 3.663 for PT). CONCLUSIONS: In patients re-operated upon for ASD, pelvic retroversion and hyperlordosis are the main mechanisms of compensation for the unbalanced spine. Patients with PT above 21° and SS below 39° are at higher risk for symptomatic ASD.
PURPOSE: Aim of this study is to estimate the risk for symptomatic adjacent segment degeneration (ASD) and examine the association between spino-pelvic parameters and ASD. METHODS: 22 patients operated upon by instrumented lumbar or lumbosacral spinal fusion and re-operated upon for ASD were enrolled in the study. 83 consecutive patients with the same surgery and never re-operated upon were the controls. Pelvic incidence, sacral slope (SS), pelvic tilt (PT), and lumbar lordosis were calculated. RESULTS:Patients with ASD had significantly lower SS (p = 0.005) and higher PT values (p < 0.001). Patients with SS <39° or PT >21°, were at higher risk for symptomatic ASD (relative risk 1.73 for SS and 3.663 for PT). CONCLUSIONS: In patients re-operated upon for ASD, pelvic retroversion and hyperlordosis are the main mechanisms of compensation for the unbalanced spine. Patients with PT above 21° and SS below 39° are at higher risk for symptomatic ASD.
Authors: Paul Park; Hugh J Garton; Vishal C Gala; Julian T Hoff; John E McGillicuddy Journal: Spine (Phila Pa 1976) Date: 2004-09-01 Impact factor: 3.468
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