|Title:||Diffuse idiopathic skeletal hyperostosis (DISH) is a risk factor for further surgery in short-segment lumbar interbody fusion.|
|Authors:||Otsuki, Bungo |
|Author's alias:||大槻, 文悟|
|Keywords:||Diffuse idiopathic skeletal|
Lumbar interbody fusion
Adjacent segment disease
Cox proportional hazards
|Publisher:||Springer Berlin Heidelberg|
|Journal title:||European spine journal|
|Abstract:||[Purpose] To elucidate the effect of diffuse idiopathic skeletal hyperostosis (DISH) on the clinical results of short-segment lumbar interbody fusion (LIF) for the treatment of degenerative lumbar spinal diseases. [Methods] The 208 patients who underwent one- or two-level LIF were selected as the subjects of this study. Patients with prior lumbar fusion surgery or follow-up <1 year were excluded. Outcome measures were surgery-free survival or the need for further surgery for pseudoarthrosis and/or adjacent segment disease (ASD). The Cox proportional-hazards model was used to identify possible risk factors (DISH, age, sex, number of levels fused, level of the lowest instrumented vertebra, and laminectomy adjacent to the index fused levels) for further surgery. [Results] Among the 208 patients (39 with DISH), 21 patients required further surgery during follow-up. Cox analysis showed that DISH (hazard ratio = 5.46) and two-level fusion (hazard ratio = 2.83) were significant independent predictors of further surgery. Age, sex, level of the lowest instrumented vertebra, and laminectomy adjacent to the index fused levels were not significant predictors. [Conclusions] DISH after short-segment LIF surgery is a significant risk factor for further surgery because of pseudoarthrosis or ASD.|
|Description:||First online: 01 October 2014|
|Rights:||The final publication is available at Springer via http://dx.doi.org/10.1007/s00586-014-3603-5.|
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|Appears in Collections:||Journal Articles |
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