Open AccessWhat is the Rate of Lumbar Adjacent Segment Disease after Percutaneous versus Open Fusion?
Author(s) -
Radcliff Kristen E,
Kepler Christopher K,
Maaieh Motasem,
Anderson D Greg,
Rihn Jeffrey,
Albert Todd,
Vaccaro Alex,
Hilibrand Alan
Publication year - 2014
Publication title -
orthopaedic surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.666
H-Index - 23
eISSN - 1757-7861
pISSN - 1757-7853
DOI - 10.1111/os.12103
Subject(s) - medicine , percutaneous , surgery , lumbar , dermatome , medical record , incidence (geometry) , lumbar spine , spinal fusion , optics , physics
Objective Adjacent segment disease ( ASD ) requiring treatment or re‐operation is a common problem after surgery on the lumbar spine. The hypothesis of this retrospective study was that ASD occurs less often following lumbar spine fusion in patients who undergo percutaneous minimally invasive ( MIS ) instrumentation than in those in whom open instrumentation is used. Methods A case‐control study was performed on consecutive patients who had undergone staged single or two level anterior lumbar interbody fusion for degenerative conditions followed by open or MIS instrumentation from 2002 to 2005 in our institution. ASD was defined as that necessitating additional procedures for new symptoms related to an adjacent lumbar dermatome. Results One hundred and seventeen patients met the inclusion criteria. Of these, 53 had been followed up by chart or medical record review for longer than one year. There were 23 patients in the MIS group and 30 in the open group. Of the 30 patients in the open group, 9 had developed ASD (30%). Of the 23 patients in the MIS group, 7 had developed ASD (30%). This difference is not statistically significant ( P = 1.00). Conclusion Contrary to our hypothesis, there was no significant difference in incidence of ASD in patients who had underwent open versus percutaneous instrumentation following anterior lumbar interbody fusion.