전요천추부 유합술 후 인접분절의 변화와 임상적 결과

초록

Purpose: To analyze the clinical and radiological results of whole lumbosacral fusion, and to identify whether an extension of the fusion level is required. Materials and Methods: A retrospective review was carried out on 40 patients who had undergone whole lumbosacral fusion. The adjacent segment changes were evaluated by the radiological findings including intervertebral space narrowing, traction spur, endplate sclerosis and vacuum phenomenon. The clinical results were evaluated using a visual analogue scale (VAS) and Oswestry disability index (ODI). Results: The mean age was 63.8 years and the mean follow-up period was 41.7 months. At the last follow-up, adjacent segment changes were observed in 12 cases of intervertebral space narrowing, 15 cases of traction spur, 20 cases of endplate sclerosis and 8 cases of vacuum phenomenon. In the clinical results, the VAS was improved to 4.0 points from 7.6 points, and the ODI improved to 43.9% from 86.0%. There were no revision cases due to adjacent segment problems. Conclusion: Whole lumbosacral fusion in spinal stenosis with degenerative lumbar scoliosis was concomitant with some adjacent segment problems, but presented favorable outcomes. For the prevention of junctional problem, caution should be taken when extending the fusion level to the proximal level in whole lumbosacral fusion.

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