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Adjacent Intervertebral Disk Height Decrease Phenomenon After Single-Level Transforaminal Lumbar Interbody Fusion of

Fei Zou1, Shuo Yang1, Jianyuan Jiang1

  • 1Department of Orthopaedics, Huashan Hospital, Fudan University, Shanghai, China.

World Neurosurgery
|April 28, 2019
PubMed
Summary
This summary is machine-generated.

Adjacent intervertebral disk height decrease after lumbar fusion is common (58.8%). Older age, increased lumbar lordosis, and facet sagittalization are key risk factors for this phenomenon following transforaminal lumbar interbody fusion (TLIF).

Keywords:
Adjacent intervertebral diskDisk height decreaseIntervertebral height distractionRadiographic studyTransforaminal lumbar interbody fusion

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Area of Science:

  • Spine surgery
  • Orthopedics
  • Radiology

Background:

  • Lumbar intervertebral fusion can increase intradiskal pressure, leading to adjacent segment degeneration.
  • The incidence and risk factors for adjacent intervertebral disk height decrease post-fusion are not well-established.
  • This study investigates the phenomenon after single-level transforaminal lumbar interbody fusion (TLIF).

Purpose of the Study:

  • To determine the incidence rate of adjacent intervertebral disk height decrease after TLIF.
  • To identify risk factors associated with this decrease.
  • To analyze the relationship between surgical distraction and adjacent segment height.

Main Methods:

  • Retrospective review of 68 patients undergoing L4-L5 TLIF.
  • Collected patient demographics (age, sex, BMI) and radiographic parameters (lumbar lordosis, facet sagittalization, Pfirrmann grade, distraction/reduction heights).
  • Patients categorized into groups based on L3-L4 intervertebral height changes.

Main Results:

  • 58.8% of patients (40/68) experienced L3-L4 intervertebral height decrease.
  • The decrease group was significantly older (mean age 62.05 vs. 56.14 years).
  • Higher mean facet sagittalization angle (67.5° vs. 55.43°) and preoperative lumbar lordosis were observed in the decrease group.

Conclusions:

  • L4-L5 intervertebral space distraction during TLIF can reduce adjacent L3-L4 segment height.
  • Age, preoperative lumbar lordosis, and facet joint sagittalization are significant risk factors.
  • These findings highlight the importance of considering patient-specific factors in TLIF surgery.