STUDY DESIGN: Segmental deformations of the lumbar spine in asymptomatic volunteers measured radiologically were compared with those in patients who underwent anterior interbody fusion. OBJECTIVE: To determine the effects of anterior lumbar interbody fusion on the juxta-fused segments. SUMMARY OF BACKGROUND DATA: Stiffness of a spinal segment after fusion was thought to be the cause of the degeneration process at the juxta-fused segments. METHODS: Segmental deformations of the lumbar spine, from maximum extension to maximum flexion, in 30 asymptomatic volunteers and 52 pain-free patients who had single-level L4-L5 or double-level L4-S1 fusion were measured and compared. RESULTS: The total flexibility of the lumbar spine was decreased after a single-level fusion and further decreased after double-level fusions. The segmental deformations of the juxta-fused segments also were decreased after either a single- or double-level fusion. CONCLUSIONS: During normal flexion and extension of the lumbar spine, the juxta-fused segments were not deformed beyond their physiological limits after fusion. Thus, accelerated degeneration observed at a juxta-fused segment is unlikely to be attributable to hypermobility.
STUDY DESIGN: Segmental deformations of the lumbar spine in asymptomatic volunteers measured radiologically were compared with those in patients who underwent anterior interbody fusion. OBJECTIVE: To determine the effects of anterior lumbar interbody fusion on the juxta-fused segments. SUMMARY OF BACKGROUND DATA: Stiffness of a spinal segment after fusion was thought to be the cause of the degeneration process at the juxta-fused segments. METHODS: Segmental deformations of the lumbar spine, from maximum extension to maximum flexion, in 30 asymptomatic volunteers and 52 pain-freepatients who had single-level L4-L5 or double-level L4-S1 fusion were measured and compared. RESULTS: The total flexibility of the lumbar spine was decreased after a single-level fusion and further decreased after double-level fusions. The segmental deformations of the juxta-fused segments also were decreased after either a single- or double-level fusion. CONCLUSIONS: During normal flexion and extension of the lumbar spine, the juxta-fused segments were not deformed beyond their physiological limits after fusion. Thus, accelerated degeneration observed at a juxta-fused segment is unlikely to be attributable to hypermobility.
Authors: Masoud Malakoutian; David Volkheimer; John Street; Marcel F Dvorak; Hans-Joachim Wilke; Thomas R Oxland Journal: Eur Spine J Date: 2015-06-09 Impact factor: 3.134