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Efficacy of interspinous device on adjacent segment degeneration after single level posterior lumbar interbody fusion: a minimum 2-year follow-up

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Author(s)
Kwang Ryeol KimChang Kyu LeeIn Soo Kim
Keimyung Author(s)
Kim, In Soo
Department
Dept. of Neurosurgery (신경외과학)
Journal Title
Br J Neurosurg
Issued Date
2021
Volume
35
Issue
6
Keyword
Lumbar spinal stenosislumbar discposterior spinal instrumentationfusionmagnetic resonance imagingX-ray
Abstract
Objective:
Adjacent segment degeneration (ASD) is a well-known problem of posterior lumbar interbody fusion (PLIF). A device for interspinous assisted motion (DIAM) has been recently applied at the adjacent segment to pedicle screw instrumentation to create a dynamic transition zone. The aim of this study was to determine whether DIAM implantation at the adjacent segment could reduce the occurrence of radiologic and symptomatic ASD.

Methods:
This retrospective study reviewed 51 patients who underwent PLIF with or without DIAM between 2005 and 2016. They were followed up for more than 24 months. The mean follow-up was over 5 years. Fourteen patients underwent PLIF with DIAM implantation at the cephalad level (Group A) and 37 patients received PLIF only (Group B). In radiologic ASD, several parameters were measured using pre- and post-operative radiographs and magnetic resonance image for lumbar degenerative disease and paraspinal muscle. Visual analogue scale (VAS) and Roland-Morris Disability Questionnaire (RMDQ) scores of back and leg were used to investigate symptomatic ASD.

Results:
In postoperative radiographic changes, disc height narrowing and progression of spondylolisthesis at adjacent segment were significantly less in group A than those in group B (0.58 mm versus 1.17 mm, p = 0.038 and 0.30 mm versus 1.69 mm, p = 0.041, respectively). In clinical assessments, back VAS and RMDQ scores improved significantly more in group A (−4.07 versus −2.54, p = 0.029 and −7.57 versus −5.43, p = 0.016, respectively).

Conclusion:
DIAM implantation with single-level PLIF could prevent disc height narrowing and progression of spondylolisthesis at adjacent segment. Clinically, DIAM implantation reduced back pain and disability. Therefore, DIAM implantation could help slow the progression of both radiologic and symptomatic ASD.
Keimyung Author(s)(Kor)
김인수
Publisher
School of Medicine (의과대학)
Citation
Kwang Ryeol Kim et al. (2021). Efficacy of interspinous device on adjacent segment degeneration after single level posterior lumbar interbody fusion: a minimum 2-year follow-up. Br J Neurosurg, 35(6), 757–765. doi: 10.1080/02688697.2020.1812516
Type
Article
ISSN
1360-046X
Source
https://www.tandfonline.com/doi/full/10.1080/02688697.2020.1812516?scroll=top&needAccess=true
DOI
10.1080/02688697.2020.1812516
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/43989
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학)
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