Analysis of Risk Factors for Postoperative Progressive Segment Degeneration at the Decompression and Non-decompression Segments after Minimally Invasive Lumbar Decompression Surgery: A 5-year Follow-up Study
Introduction: The risk factors for the development of progressive segment degeneration (PSD) after decompression surgery are still unknown. In this study, the risk factors for PSD in patients who undergo decompression surgery for lumbar spinal stenosis with and without coexisting spondylolisthesis a...
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The Japanese Society for Spine Surgery and Related Research
2025-01-01
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| Series: | Spine Surgery and Related Research |
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| Online Access: | https://www.jstage.jst.go.jp/article/ssrr/9/1/9_2024-0014/_pdf/-char/en |
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| author | Hasibullah Habibi Hiromitsu Toyoda Hidetomi Terai Kentaro Yamada Minori Kato Akinobu Suzuki Shinji Takahashi Koji Tamai Masayoshi Iwamae Yuta Sawada Yuto Kobayashi Yuki Okamura Hiroaki Nakamura |
| author_facet | Hasibullah Habibi Hiromitsu Toyoda Hidetomi Terai Kentaro Yamada Minori Kato Akinobu Suzuki Shinji Takahashi Koji Tamai Masayoshi Iwamae Yuta Sawada Yuto Kobayashi Yuki Okamura Hiroaki Nakamura |
| author_sort | Hasibullah Habibi |
| collection | DOAJ |
| description | Introduction: The risk factors for the development of progressive segment degeneration (PSD) after decompression surgery are still unknown. In this study, the risk factors for PSD in patients who undergo decompression surgery for lumbar spinal stenosis with and without coexisting spondylolisthesis and scoliosis were examined, focusing on decompression and non-decompression segments.
Methods: We reviewed the data of patients with >5 years of postoperative follow up. Radiographic PSD was defined as either the development of an anterolisthesis or retrolisthesis of >3 mm or a decrease in disc height of >3 mm during the 5-year follow up. On the basis of intervertebral segments, the association between PSD and other preoperative clinical findings was analyzed.
Results: Overall, 840 lumbar segments (L1-L2 to L5-S1) in 168 patients, with a mean age of 69.5±9.2 years, met the inclusion criteria. PSD was observed in 162 (19.3%) lumbar segments. A logistic regression model identified that Cobb angle 10° (OR 2.53, 95% CI 1.50-4.24), spondylolisthesis 3 mm (OR 4.447, 95% CI 2.06-9.58), and level of segments were more likely to have PSD at the non-decompression level; additionally, lateral listhesis 3 mm (OR 2.91, 95% CI 1.08-7.81) was more likely to have PSD in the decompression segments. In clinical outcomes in patients with PSD at baseline and the 5-year follow-up, no significant difference was found.
Conclusions: Even though PSD does not correlate with worsening symptoms, our study confirms that a higher degree of pre-existing disc degeneration is indicative of a higher PSD in 5 years. |
| format | Article |
| id | doaj-art-c0c520f1063e40fe852cd6b59a38305f |
| institution | Kabale University |
| issn | 2432-261X |
| language | English |
| publishDate | 2025-01-01 |
| publisher | The Japanese Society for Spine Surgery and Related Research |
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| series | Spine Surgery and Related Research |
| spelling | doaj-art-c0c520f1063e40fe852cd6b59a38305f2025-02-09T23:30:07ZengThe Japanese Society for Spine Surgery and Related ResearchSpine Surgery and Related Research2432-261X2025-01-0191222910.22603/ssrr.2024-00142024-0014Analysis of Risk Factors for Postoperative Progressive Segment Degeneration at the Decompression and Non-decompression Segments after Minimally Invasive Lumbar Decompression Surgery: A 5-year Follow-up StudyHasibullah Habibi0Hiromitsu Toyoda1Hidetomi Terai2Kentaro Yamada3Minori Kato4Akinobu Suzuki5Shinji Takahashi6Koji Tamai7Masayoshi Iwamae8Yuta Sawada9Yuto Kobayashi10Yuki Okamura11Hiroaki Nakamura12Department of Orthopaedic Surgery, Osaka Metropolitan University Graduate School of MedicineDepartment of Orthopaedic Surgery, Osaka Metropolitan University Graduate School of MedicineDepartment of Orthopaedic Surgery, Osaka Metropolitan University Graduate School of MedicineDepartment of Orthopedic and Trauma Research, Tokyo Medical and Dental UniversityDepartment of Orthopaedic Surgery, Osaka Metropolitan University Graduate School of MedicineDepartment of Orthopaedic Surgery, Osaka Metropolitan University Graduate School of MedicineDepartment of Orthopaedic Surgery, Osaka Metropolitan University Graduate School of MedicineDepartment of Orthopaedic Surgery, Osaka Metropolitan University Graduate School of MedicineDepartment of Orthopaedic Surgery, Osaka Metropolitan University Graduate School of MedicineDepartment of Orthopaedic Surgery, Osaka Metropolitan University Graduate School of MedicineDepartment of Orthopaedic Surgery, Osaka Metropolitan University Graduate School of MedicineDepartment of Orthopaedic Surgery, Osaka Metropolitan University Graduate School of MedicineDepartment of Orthopaedic Surgery, Osaka Metropolitan University Graduate School of MedicineIntroduction: The risk factors for the development of progressive segment degeneration (PSD) after decompression surgery are still unknown. In this study, the risk factors for PSD in patients who undergo decompression surgery for lumbar spinal stenosis with and without coexisting spondylolisthesis and scoliosis were examined, focusing on decompression and non-decompression segments. Methods: We reviewed the data of patients with >5 years of postoperative follow up. Radiographic PSD was defined as either the development of an anterolisthesis or retrolisthesis of >3 mm or a decrease in disc height of >3 mm during the 5-year follow up. On the basis of intervertebral segments, the association between PSD and other preoperative clinical findings was analyzed. Results: Overall, 840 lumbar segments (L1-L2 to L5-S1) in 168 patients, with a mean age of 69.5±9.2 years, met the inclusion criteria. PSD was observed in 162 (19.3%) lumbar segments. A logistic regression model identified that Cobb angle 10° (OR 2.53, 95% CI 1.50-4.24), spondylolisthesis 3 mm (OR 4.447, 95% CI 2.06-9.58), and level of segments were more likely to have PSD at the non-decompression level; additionally, lateral listhesis 3 mm (OR 2.91, 95% CI 1.08-7.81) was more likely to have PSD in the decompression segments. In clinical outcomes in patients with PSD at baseline and the 5-year follow-up, no significant difference was found. Conclusions: Even though PSD does not correlate with worsening symptoms, our study confirms that a higher degree of pre-existing disc degeneration is indicative of a higher PSD in 5 years.https://www.jstage.jst.go.jp/article/ssrr/9/1/9_2024-0014/_pdf/-char/enlumbar spinal stenosisminimally invasive lumbar decompression surgeryprogressive segment degenerationadjacent segment disease5-year follow-up study |
| spellingShingle | Hasibullah Habibi Hiromitsu Toyoda Hidetomi Terai Kentaro Yamada Minori Kato Akinobu Suzuki Shinji Takahashi Koji Tamai Masayoshi Iwamae Yuta Sawada Yuto Kobayashi Yuki Okamura Hiroaki Nakamura Analysis of Risk Factors for Postoperative Progressive Segment Degeneration at the Decompression and Non-decompression Segments after Minimally Invasive Lumbar Decompression Surgery: A 5-year Follow-up Study Spine Surgery and Related Research lumbar spinal stenosis minimally invasive lumbar decompression surgery progressive segment degeneration adjacent segment disease 5-year follow-up study |
| title | Analysis of Risk Factors for Postoperative Progressive Segment Degeneration at the Decompression and Non-decompression Segments after Minimally Invasive Lumbar Decompression Surgery: A 5-year Follow-up Study |
| title_full | Analysis of Risk Factors for Postoperative Progressive Segment Degeneration at the Decompression and Non-decompression Segments after Minimally Invasive Lumbar Decompression Surgery: A 5-year Follow-up Study |
| title_fullStr | Analysis of Risk Factors for Postoperative Progressive Segment Degeneration at the Decompression and Non-decompression Segments after Minimally Invasive Lumbar Decompression Surgery: A 5-year Follow-up Study |
| title_full_unstemmed | Analysis of Risk Factors for Postoperative Progressive Segment Degeneration at the Decompression and Non-decompression Segments after Minimally Invasive Lumbar Decompression Surgery: A 5-year Follow-up Study |
| title_short | Analysis of Risk Factors for Postoperative Progressive Segment Degeneration at the Decompression and Non-decompression Segments after Minimally Invasive Lumbar Decompression Surgery: A 5-year Follow-up Study |
| title_sort | analysis of risk factors for postoperative progressive segment degeneration at the decompression and non decompression segments after minimally invasive lumbar decompression surgery a 5 year follow up study |
| topic | lumbar spinal stenosis minimally invasive lumbar decompression surgery progressive segment degeneration adjacent segment disease 5-year follow-up study |
| url | https://www.jstage.jst.go.jp/article/ssrr/9/1/9_2024-0014/_pdf/-char/en |
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