Analysis of preoperative risk factors of adjacent segment disease after transforaminal lumbar interbody fusion

Byvaltsev V.A.

Irkutsk State Medical University;
Private Healthcare Institution «Clinical Hospital «Russian Railways-Medicine»;
Irkutsk State Medical Academy of Postgraduate Education

Kalinin A.A.

Irkutsk State Medical University;
Private Healthcare Institution «Clinical Hospital «Russian Railways-Medicine»

Pestryakov Yu.Ya.

Irkutsk State Medical University

Spiridonov A.V.

Irkutsk State Medical University;
Regional Clinical Hospital

ORCID: 0000-0003-3244-4688

Analysis of preoperative risk factors of adjacent segment disease after transforaminal lumbar interbody fusion

Authors:

Byvaltsev V.A., Kalinin A.A., Pestryakov Yu.Ya., Spiridonov A.V.

More about the authors

Journal: Burdenko's Journal of Neurosurgery. 2023;87(2): 48‑55

DOI: 10.17116/neiro20238702148

Read: 2693 times

To cite this article:

Byvaltsev VA, Kalinin AA, Pestryakov YuYa, Spiridonov AV. Analysis of preoperative risk factors of adjacent segment disease after transforaminal lumbar interbody fusion. Burdenko's Journal of Neurosurgery. 2023;87(2):48‑55. (In Russ., In Engl.)
https://doi.org/10.17116/neiro20238702148

Подписка 2025-2 (Burdenko's Journal of Neurosurgery)

Использование инфографики авторами научных работ

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OBJECTIVE

To evaluate the effect of preoperative biometric and instrumental parameters of adjacent FSU on the risk of ASDd after transforaminal lumbar interbody fusion and determine personalized neurosurgical approach.

MATERIAL AND METHODS

We retrospectively studied patients after single-level transforaminal lumbar interbody fusion (group I, n=54), single-level transforaminal lumbar interbody fusion and interspinous stabilization of adjacent level (group II, n=55), preventive rigid fusion of adjacent segment (group III, n=56). Preoperative parameters and long-term clinical outcomes were assessed.

RESULTS

Paired correlation analysis established the main predictors of ASDd. Regression analysis determined absolute values of these predictors for each type of surgical intervention.

CONCLUSION

Surgical intervention at the level of asymptomatic proximal adjacent segment is recommended as interspinous stabilization for moderate degenerative lesions, BMI <25 kg/m², difference between pelvic index and lumbar lordosis 10.5—15°, segmental lordosis 6.5—10.5°. In case of severe degenerative lesions, BMI 25.1—31.1 kg/m², significant deviations of spinal-pelvic parameters (segmental lordosis 5.5—10.5°, difference between pelvic index and lumbar lordosis 15.2—20°), preventive rigid stabilization is indicated.

Keywords:

lumbosacral spine

degenerative disease

posterior lumbar fixation

adjacent segment disease

prognosis

risk factors

Authors:

Byvaltsev V.A.

Irkutsk State Medical University;
Private Healthcare Institution «Clinical Hospital «Russian Railways-Medicine»;
Irkutsk State Medical Academy of Postgraduate Education

Kalinin A.A.

Irkutsk State Medical University;
Private Healthcare Institution «Clinical Hospital «Russian Railways-Medicine»

Pestryakov Yu.Ya.

Irkutsk State Medical University

Spiridonov A.V.

Irkutsk State Medical University;
Regional Clinical Hospital

ORCID: 0000-0003-3244-4688

Received:

26.05.2022

Accepted:

27.01.2023

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