Operative treatment of the degenerated segment adjacent to a lumbar fusion

Fourteen patients with a previous lumbosacral fusion underwent neural decompression and fusion of degenerated adjacent motion segment. The most common level was L3-L4, and there was an average of 3.2 (range 1-7) previous lumbosacral surgical procedures. The average interval from the first fusion unt...

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Bibliographic Details
Published in:Spine (Philadelphia, Pa. 1976) Pa. 1976), 1994-03, Vol.19 (5), p.531-536
Main Authors: WHITECLOUD, T. S, DAVIS, J. M, OLIVE, P. M
Format: Article
Language:English
Subjects:
Biological and medical sciences
Diseases of the osteoarticular system
Diseases of the spine
Female
Follow-Up Studies
Humans
Internal Fixators
Intervertebral Disc Displacement - surgery
Lumbar Vertebrae - surgery
Male
Medical sciences
Middle Aged
Osteoporosis - epidemiology
Postoperative Complications - epidemiology
Postoperative Complications - surgery
Reoperation
Retrospective Studies
Sacrum - surgery
Spinal Fusion
Time Factors
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Summary:Fourteen patients with a previous lumbosacral fusion underwent neural decompression and fusion of degenerated adjacent motion segment. The most common level was L3-L4, and there was an average of 3.2 (range 1-7) previous lumbosacral surgical procedures. The average interval from the first fusion until operative intervention on the degenerated adjacent segment was 11.5 years (range 3-29 years). Five patients had an uninstrumented fusion, of which only one progressed to arthrodesis. Three of these five patients with pseudarthrosis after uninstrumented fusion--and the remaining nine patients--had fusions with instrumentation. Ten of twelve instrumented fusions progressed to solid arthrodesis. The pseudoarthrosis rate of 80% was decreased to 17% with the use of supplemental instrumentation. There was a significant number of complications and poor results, especially in patients with advanced osteoporosis and those with a short interval between adjacent segment degeneration, respectively. Eleven of 14 patients reported some postoperative pain relief.
ISSN:0362-2436
1528-1159
DOI:10.1097/00007632-199403000-00007