Progression of Coronal Cobb Angle after Short-Segment Lumbar Interbody Fusion in Patients with Degenerative Lumbar Stenosis

Nam Lee, Seong Yi, DongAh Shin, Keung Nyun Kim, Do Heum Yoon, Yoon Ha

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Objective The progression of scoliosis after fusion surgery is a poor prognostic factor of long-term outcomes in patients with degenerative lumbar stenosis (DLS). In this study we aimed to investigate changes in coronal alignment and identify risk factors related to progression of scoliosis after fusion. Methods There were 540 patients with symptomatic DLS treated by short-segment lumbar fusion surgery. Among them, 50 patients had coronal Cobb angles >10°at the final follow-up. Sixteen patients had increases >5°(progression group), and 34 patients had increases <5°(nonprogression group). Radiologic parameters that may affect the progression of scoliosis were compared. Results The mean progression of the Cobb angle was 7.92°in the progression group and 1.25°in the nonprogression group. The progression group had significantly longer follow-up periods and a lower preoperative Cobb angle. The apical vertebra (AV) of the major curve was more frequently thoracic in the progression group. Progression of the Cobb angle was correlated with the follow-up period, preoperative Cobb angle, and location of the AV. Multivariate regression analysis showed that progression of the Cobb angle was significantly associated with a lower preoperative Cobb angle, and both facet degeneration of the upper instrumented vertebra at the fusion site and vertebral spur formation on the concave side also appeared to be associated with progression of the Cobb angle. Conclusions The global magnitude of progression of the Cobb angle after short-segment lumbar fusion surgery in patients with DLS is similar to the natural curve progression of adult degenerative scoliosis.

Original languageEnglish
Pages (from-to)510-516
Number of pages7
JournalWorld Neurosurgery
Volume89
DOIs
Publication statusPublished - 2016 May 1

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Pathologic Constriction
Scoliosis
Spine
Preoperative Period
Thorax
Multivariate Analysis
Regression Analysis

All Science Journal Classification (ASJC) codes

  • Surgery
  • Clinical Neurology

Cite this

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title = "Progression of Coronal Cobb Angle after Short-Segment Lumbar Interbody Fusion in Patients with Degenerative Lumbar Stenosis",
abstract = "Objective The progression of scoliosis after fusion surgery is a poor prognostic factor of long-term outcomes in patients with degenerative lumbar stenosis (DLS). In this study we aimed to investigate changes in coronal alignment and identify risk factors related to progression of scoliosis after fusion. Methods There were 540 patients with symptomatic DLS treated by short-segment lumbar fusion surgery. Among them, 50 patients had coronal Cobb angles >10°at the final follow-up. Sixteen patients had increases >5°(progression group), and 34 patients had increases <5°(nonprogression group). Radiologic parameters that may affect the progression of scoliosis were compared. Results The mean progression of the Cobb angle was 7.92°in the progression group and 1.25°in the nonprogression group. The progression group had significantly longer follow-up periods and a lower preoperative Cobb angle. The apical vertebra (AV) of the major curve was more frequently thoracic in the progression group. Progression of the Cobb angle was correlated with the follow-up period, preoperative Cobb angle, and location of the AV. Multivariate regression analysis showed that progression of the Cobb angle was significantly associated with a lower preoperative Cobb angle, and both facet degeneration of the upper instrumented vertebra at the fusion site and vertebral spur formation on the concave side also appeared to be associated with progression of the Cobb angle. Conclusions The global magnitude of progression of the Cobb angle after short-segment lumbar fusion surgery in patients with DLS is similar to the natural curve progression of adult degenerative scoliosis.",
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Progression of Coronal Cobb Angle after Short-Segment Lumbar Interbody Fusion in Patients with Degenerative Lumbar Stenosis. / Lee, Nam; Yi, Seong; Shin, DongAh; Kim, Keung Nyun; Yoon, Do Heum; Ha, Yoon.

In: World Neurosurgery, Vol. 89, 01.05.2016, p. 510-516.

Research output: Contribution to journalArticle

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T1 - Progression of Coronal Cobb Angle after Short-Segment Lumbar Interbody Fusion in Patients with Degenerative Lumbar Stenosis

AU - Lee, Nam

AU - Yi, Seong

AU - Shin, DongAh

AU - Kim, Keung Nyun

AU - Yoon, Do Heum

AU - Ha, Yoon

PY - 2016/5/1

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N2 - Objective The progression of scoliosis after fusion surgery is a poor prognostic factor of long-term outcomes in patients with degenerative lumbar stenosis (DLS). In this study we aimed to investigate changes in coronal alignment and identify risk factors related to progression of scoliosis after fusion. Methods There were 540 patients with symptomatic DLS treated by short-segment lumbar fusion surgery. Among them, 50 patients had coronal Cobb angles >10°at the final follow-up. Sixteen patients had increases >5°(progression group), and 34 patients had increases <5°(nonprogression group). Radiologic parameters that may affect the progression of scoliosis were compared. Results The mean progression of the Cobb angle was 7.92°in the progression group and 1.25°in the nonprogression group. The progression group had significantly longer follow-up periods and a lower preoperative Cobb angle. The apical vertebra (AV) of the major curve was more frequently thoracic in the progression group. Progression of the Cobb angle was correlated with the follow-up period, preoperative Cobb angle, and location of the AV. Multivariate regression analysis showed that progression of the Cobb angle was significantly associated with a lower preoperative Cobb angle, and both facet degeneration of the upper instrumented vertebra at the fusion site and vertebral spur formation on the concave side also appeared to be associated with progression of the Cobb angle. Conclusions The global magnitude of progression of the Cobb angle after short-segment lumbar fusion surgery in patients with DLS is similar to the natural curve progression of adult degenerative scoliosis.

AB - Objective The progression of scoliosis after fusion surgery is a poor prognostic factor of long-term outcomes in patients with degenerative lumbar stenosis (DLS). In this study we aimed to investigate changes in coronal alignment and identify risk factors related to progression of scoliosis after fusion. Methods There were 540 patients with symptomatic DLS treated by short-segment lumbar fusion surgery. Among them, 50 patients had coronal Cobb angles >10°at the final follow-up. Sixteen patients had increases >5°(progression group), and 34 patients had increases <5°(nonprogression group). Radiologic parameters that may affect the progression of scoliosis were compared. Results The mean progression of the Cobb angle was 7.92°in the progression group and 1.25°in the nonprogression group. The progression group had significantly longer follow-up periods and a lower preoperative Cobb angle. The apical vertebra (AV) of the major curve was more frequently thoracic in the progression group. Progression of the Cobb angle was correlated with the follow-up period, preoperative Cobb angle, and location of the AV. Multivariate regression analysis showed that progression of the Cobb angle was significantly associated with a lower preoperative Cobb angle, and both facet degeneration of the upper instrumented vertebra at the fusion site and vertebral spur formation on the concave side also appeared to be associated with progression of the Cobb angle. Conclusions The global magnitude of progression of the Cobb angle after short-segment lumbar fusion surgery in patients with DLS is similar to the natural curve progression of adult degenerative scoliosis.

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