Sacroiliac Joint Degeneration After Lumbar or Lumbosacral Fusion Surgery-A Comparative Study of the Number of Fused Segments and Sacral Fusion.

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  • Additional Information
    • Source:
      Publisher: Elsevier Country of Publication: United States NLM ID: 101528275 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1878-8769 (Electronic) Linking ISSN: 18788750 NLM ISO Abbreviation: World Neurosurg Subsets: MEDLINE
    • Publication Information:
      Original Publication: New York : Elsevier
    • Subject Terms:
      Spinal Fusion*/methods ; Spinal Fusion*/adverse effects ; Sacroiliac Joint*/diagnostic imaging ; Sacroiliac Joint*/surgery ; Lumbar Vertebrae*/surgery ; Lumbar Vertebrae*/diagnostic imaging ; Sacrum*/surgery ; Sacrum*/diagnostic imaging ; Low Back Pain*/surgery ; Low Back Pain*/etiology ; Low Back Pain*/diagnostic imaging; Humans ; Female ; Male ; Middle Aged ; Aged ; Postoperative Complications/diagnostic imaging ; Postoperative Complications/etiology ; Adult ; Retrospective Studies ; Lumbosacral Region/surgery ; Tomography, X-Ray Computed
    • Abstract:
      Objective: In this study, we aimed to investigate whether multi-segment fusion or fusion-to-sacrum increases sacroiliac joint (SIJ) pathology compared with single-segment fusion or a non-fused sacrum.
      Methods: This study included 116 patients who underwent lumbar or lumbosacral fusion and were followed up for 2 years. The patients were classified into single-segment fusion (n = 46) and multi-segment fusion (more than two levels, n = 70) groups and then reclassified into the non-fused sacrum (n = 68) and fusion-to-sacrum groups (n = 48). Preoperative and postoperative radiographs were used to evaluate radiographic parameters, and computed tomography (CT) was used to evaluate SIJ degeneration. Low back pain (LBP) was assessed using a visual analog scale (VAS, 0-10). Baseline and postoperative values were compared using a paired sample t-test.
      Results: LBP VAS scores significantly differed at 6 months (single-segment fusion, 3.04±1.88; multi-segment fusion, 4.83±2.33; P < 0.001) and 2 years postoperatively (single-segment fusion, 3.3±2.2; multi-segment fusion, 4.78±2.59; P = 0.094). There was no significant difference in SIJ degeneration, as assessed by CT scan, between the 2 surgical groups: 14 (30%) and 19 (27%) patients in the single-segment and multi-segment (P = 0.701) fusion groups, respectively. The LBP VAS scale showed comparable differences at 1 (non-fused sacrum, 3±2.18; fusion-to-sacrum, 3.74±2.28; P = 0.090) and 2 years postoperatively (non-fused sacrum, 3.29±2.01; fusion-to-sacrum, 4.66±2.71; P = 0.095). CT scan revealed that 18 (26%) and 15 (31%) patients in the non-fused sacrum and fusion-to-sacrum groups, respectively, developed SIJ arthritis; however, there was no significant intergroup difference (P = 0.574).
      Conclusions: SIJ degeneration occurs independent of the number of fused segments or sacrum involvement.
      (Copyright © 2024 Elsevier Inc. All rights reserved.)
    • Contributed Indexing:
      Keywords: Sacroiliac joint; Spinal fusion; Spinal stenosis
    • Publication Date:
      Date Created: 20240811 Date Completed: 20241019 Latest Revision: 20241019
    • Publication Date:
      20250114
    • Accession Number:
      10.1016/j.wneu.2024.08.019
    • Accession Number:
      39128613