Effect of isolated L4/5 fusion on L5/S1 in presence or absence of preoperative L5/S1 degeneration short term outcomes | ||||
Medicine Updates | ||||
Article 6, Volume 11, Issue 11, October 2022, Page 48-59 PDF (980.27 K) | ||||
Document Type: Research project | ||||
DOI: 10.21608/muj.2022.146888.1107 | ||||
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Authors | ||||
Mohammad Fekry Elshirbiny 1; Ahmed Sameh Nada2; Assem Ahmed1 | ||||
1Neurosurgery department, faculty of medicine, mansoura university, Egypt | ||||
2Neurosurgery department, faculty of medicine , portsaid university | ||||
Abstract | ||||
Background: there is some debate about isolated L4/5 fusion and its effect on L5/S1segment, especially in presence of preoperative L5/S1degeneration and its effect on the postoperative clinical outcome. Aim of study: to evaluate the effect of isolated L4/5 fusion on radiological and clinical outcome in presence or absence of L5/S1degeneration. Method: this is a comparative retrospective study between 2 groups of patients had L4/5 degenerative spondylolisthesis underwent standard isolated L4/5posterolateral fusion surgery; the first group had a preoperative L5/S1radiological degeneration while the second group showed no preoperative L5/S1degeneration. The minimum follow up period for those patients were 2 years. Results: 41 patients were included in this study; first group included 17 patients associated with preoperative L5/S1degeneration and the second group included 24 patients with no L5/S1degeneration. There were no significant differences in clinical and radiological outcome between the two groups when compared at the final follow up. According to the radiological degeneration 4 (23.5%) patients of the first group showed accelerated degeneration while 3(12.5%) patients of the second group showed accelerated L5/S1degeneration. On the other hand 2 (11.8%) patients of the first group showed clinical L5/S1degeneration while 1(4.2%) patients of the second group showed clinical degeneration. There were no significant differences in accelerated degeneration when we compared the two groups. Conclusion:L5/S1segment could be safely spared in cases of L4/5 fusion in the presence of preoperative L5/S1degeneration if the clinical symptoms are not correlated to the degeneration. | ||||
Keywords | ||||
adjacent segment disease; spondylolithesis; fusion surgery | ||||
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