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Title: Diffuse idiopathic skeletal hyperostosis (DISH) is a risk factor for further surgery in short-segment lumbar interbody fusion.
Authors: Otsuki, Bungo  kyouindb  KAKEN_id
Fujibayashi, Shunsuke  kyouindb  KAKEN_id
Takemoto, Mitsuru
Kimura, Hiroaki
Shimizu, Takayoshi
Matsuda, Shuichi  kyouindb  KAKEN_id
Author's alias: 大槻, 文悟
Keywords: Diffuse idiopathic skeletal
Lumbar interbody fusion
Adjacent segment disease
Cox proportional hazards
Issue Date: Nov-2015
Publisher: Springer Berlin Heidelberg
Journal title: European spine journal
Volume: 24
Issue: 11
Start page: 2514
End page: 2519
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
The full-text file will be made open to the public on 1 October 2015 in accordance with publisher's 'Terms and Conditions for Self-Archiving'.
This is not the published version. Please cite only the published version.
DOI(Published Version): 10.1007/s00586-014-3603-5
PubMed ID: 25271072
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