Diario de columna vertebral

Salvaged Surgery of Non-fusion Stabilization for the Adjacent Segmental Diseases after Posterior Spinal Fusion

Abstract

Hideki Ohta, Yoshiyuki Matsumoto, Yoshikazu Nakayama, Youhei Iguchi, Hirotaka Kida and Yoshiharu Takemitsu

Posterior lumbar fusion with instrumentation provides immediate stability on spine and is an effective surgical technique in deformity correction, whereas ASD remains as a mid/long term issue. In this study, we applied posterior decompression and non-fusion stabilization with SSCS to total of 21 patients (13 males and 8 females), who had undergone posterior lumbar fusion in the previous five years and then suffered ASD. The mean age was 69.4 years (range: 49 to 85) and the mean period between the primary surgery and the revision surgery was 5 years and 9 months (range: 11 months to 18 years). Site of ASD occurrence was at; upper level on 16 patients, lower level on 4 patients and upper/lower level on 1 patient. Preoperative JOA score 14.6 improved to postoperative 23.8 at the follow-up (improvement rate: 63%). ROM of the operated segments was significantly decreased from mean 8.2 to 1.7 degrees. We applied non-fusion stabilization with SSCS to salvage ASD occurred after posterior lumbar fusion with instrumentation. In case that further spinal fusion is applied to ASD, it could cause another ASD. Therefore non-fusion stabilization seems to be meaningful.