Risk factors of revision operation and early revision for adjacent segment degeneration after lumbar fusion surgery: a case-control study

• Published in: The spine journal 2024-09, Vol.24 (9), p.1678-1689
• Main Authors: Park, Sehan, Hwang, Chang Ju, Lee, Dong-Ho, Kim, Nam Yeop, Nam, Hyun Wook, Kang, Hyun Wook, Lee, Choon Sung, Ok, Cha Hyeong, Cho, Jae Hwan
• Format: Article
• Language: English
• Subjects: Adjacent segment degeneration; Disc space height; Early revision; Lumbar fusion operation; Revision surgery; Risk factors; Sagittal parameters; Survival analysis
• ISSN: 1529-9430; 1878-1632; 1878-1632
• DOI: 10.1016/j.spinee.2024.04.013

Adjacent segment degeneration (ASD) following lumbar fusion operation is common and can occur at varying timepoints after index surgery. An early revision operation for ASD, however, signifies a short symptom-free period and might increase the risk of successive surgeries. We aimed to elucidate the overall risk factors associated with revision surgeries for ASD with distinct attention to early revisions. Retrospective, case-control study. The study included 86 patients who underwent revision operations for ASD after lumbar fusion in the revision group and 166 patients who did not for at least 5 years after index surgery. Sagittal parameters, Pfirrmann grading, facet degeneration grading, and disc space height (DSH) of adjacent segments were assessed. Revision operations within 5 years postsurgery were defined as early revision. We compared the revision and no-revision groups as well as the early- and late-revision groups. The revision group demonstrated a significantly greater preoperative C7–S1 sagittal vertical axis (SVA) (p=.001), postoperative C7–S1 SVA (p