Radiographic Changes of Adjacent Upper Segment Performed Short Segmental Lumbosacral Fusion-Does Total Laminectomy Influence Adjacent Upper (단분절 요천추 유합술 후 상위 인접 분절의 방사선학적 변화-과연 후궁 전 절제술이 상위 인접 분절 불안정성을 야기하는가?)

황대우; 신재흥; 김병민; 박영수; 이정희; 김응하

Radiographic Changes of Adjacent Upper Segment Performed Short Segmental Lumbosacral Fusion-Does Total Laminectomy Influence Adjacent Upper

Journal of Korean Society of Spine Surgery
Abbr : J Kor Spine Sur
2008, 15(1), pp.31-37
Publisher : Korean Society Of Spine Surgery
Research Area : Medicine and Pharmacy > Orthopedic Surgery

황대우 ¹, 신재흥 ¹, 김병민 ¹, 박영수 ¹, 이정희 ², 김응하 ³

¹국립의료원
²경희대학교 의과대학 정형외과학교실
³순천향대학교

Candidate

ABSTRACT

Study Design:Retrospective study. Objectives:The purpose of this study was to compare factors that influence degenerative changes in patients undergoing totallaminectomy and patients undergoing partial laminectomy. Summary of Literature Review:Lumbar or lumbosacral fusion with total or partial laminectomy may result in adjacent seg-ment problems of the upper segment. However, the differences between the two procedures that may influence adjacent seg-ment instability are still controversial. Materials and Methods:We evaluated 95 patients, followed up for at least 2 years, who had been treated with short level (atmost 2 levels) posterior lumbar interbody fusion with pedicle fixation, secondary to spinal stenosis. Treatment proceduresincluded total laminectomy (42 cases) and partial laminectomy (53 cases). We analyzed the preoperative status of the interverte-bral discs (Thompson grade), difference of disc height, and difference between preoperative segmental sagittal angle and lastfollow-up sagittal angle. We excluded cases that required revision secondary to infection, nonunion, or hematoma formation.However, we included cases that required revision due to adjacent segmental problems during the follow-up period. Results:The mean age of the patients treated with total laminectomy was 59.0± 10.9 years, and of the patients treated withpartial laminectomy was 58.8± 10.2 years. The preoperative Thompson grade showed no statistical difference. The difference indisc height and segmental sagittal angle between the preoperative and last follow-up examinations showed no statistical dif-ference between the two groups. Conclusions:There was no significant difference in the radiographic or clinical outcomes based on removal or preservation ofposterior structures. Nevertheless, we need further follow-up to evaluate adjacent segment degeneration.

KEYWORDS

Spinal fusion, Adjacent segment, Total laminectomy

Citation status

* References for papers published after 2023 are currently being built.

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