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European Spine Journal

Erschienen in:

10.08.2023 | Original Article

Risk factors for mechanical complications after fusion extension surgery for lumbar adjacent segment disease

verfasst von: Young-Hoon Kim, Kee-Yong Ha, Joonghyun Ahn, Hyung-Youl Park, Dong-Gune Chang, Jae-Hak Lim, Sang-Il Kim

Erschienen in: European Spine Journal | Ausgabe 1/2024

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Abstract

Purpose

Adjacent segment disease (ASD) is a common complication in fusion surgery. In the event of solid segmental fusion, previous implants can be removed or preserved during fusion extension for ASD. To compare the surgical outcomes of patients with and without implants and analyzes the risk factors for postoperative mechanical complications.

Methods

Patients who underwent fusion extension for lumbar ASD from 2011 to 2019 with a minimum 2 year follow-up were retrospectively reviewed. Spinopelvic parameters were measured preoperatively and postoperatively. Clinical outcomes and surgical complications were compared between groups with implants preserved and removed. Risk factors for mechanical complications, including clinical, surgical, and radiographic factors were analyzed.

Results

Sixty-nine patients (mean age, 69.9 ± 6.9 years) were included. The mean numbers of initial and extended fused segments were 2.8 ± 0.7 and 2.7 ± 0.7, respectively. Previous implants were removed in 43 patients (R group) and preserved in 26 patients (P group). Both groups showed an improvement in clinical outcomes without between-group differences. The operation time was significantly longer in R group (260 vs 207 min, p < 0.001). Mechanical complications occurred in 13 patients (12 in R group and 1 in P group) and reoperation was needed in 3 patients (R group). Implant removal, index fusion surgery including L5-S1, and postoperative sagittal malalignment were risk factors for mechanical complications.

Conclusion

Implant removal was a risk factor for mechanical complications. Index fusion surgery including L5-S1 and postoperative sagittal malalignment were also risk factors for mechanical complications.

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Titel: Risk factors for mechanical complications after fusion extension surgery for lumbar adjacent segment disease
verfasst von: Young-Hoon Kim
Kee-Yong Ha
Joonghyun Ahn
Hyung-Youl Park
Dong-Gune Chang
Jae-Hak Lim
Sang-Il Kim
Publikationsdatum: 10.08.2023
Verlag: Springer Berlin Heidelberg
Erschienen in: European Spine Journal / Ausgabe 1/2024
Print ISSN: 0940-6719
Elektronische ISSN: 1432-0932
DOI: https://doi.org/10.1007/s00586-023-07880-5

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Risk factors for mechanical complications after fusion extension surgery for lumbar adjacent segment disease