PURPOSE: We determined the incidence of and risk factors for clinical adjacent segment pathology (C-ASP) requiring additional surgeries among @entity1 previously treated with one-segment lumbar decompression and fusion surgery. METHODS: We retrospectively analysed 161 consecutive @entity1 who underwent one-segment lumbar decompression and fusion surgery for L4 degenerative spondylolisthesis. @entity1 age, sex, body mass index (BMI), facet orientation and tropism, laminar inclination angle, spinal canal stenosis ratio [on myelography and magnetic resonance imaging (MRI)], preoperative adjacent segment instability, arthrodesis type, @entity1516 , segmental @entity1515 at L4-5, and the present L4 slip were evaluated by a log-rank test using the Kaplan-Meier method. A multivariate Cox proportional-hazards model was used to analyse all factors found significant by the log-rank test. RESULTS: Of 161 @entity1 , 22 @entity1 (13.7  %) had additional surgeries at cranial segments located adjacent to the index surgery's location. Pre-existing canal stenosis >= 47  % at the adjacent segment on myelography, greater facet tropism, and high BMI were significant risk factors for C-ASP. The estimated incidences at 10  years postoperatively for each of these factors were 51.3, 39.6, and 32.5  %, and the risks for C-ASP were 4.9, 3.7, and, 3.1 times higher than their counterparts, respectively. Notably, spinal canal stenosis on myelography, but not on MRI, was found to be a significant risk factor for C-ASP (log-rank test P  <  0.0001 and 0.299, respectively). CONCLUSIONS: Pre-existing @entity612 , greater facet tropism, and higher BMI significantly increased C-ASP risk. Myelography is a more accurate method for detecting latent spinal canal stenosis as a risk factor for C-ASP.

Risk factors for adjacent segment pathology requiring additional surgery after single-level spinal fusion: impact of pre-existing XXXX demonstrated by preoperative myelography.

@entity1 :: ('9606', 'Species') :: ['patients', 'Patient'] @entity1515 :: ('MESH:D008141', 'Disease') :: ['lordosis'] @entity612 :: ('MESH:D013130', 'Disease') :: ['spinal stenosis'] @entity1516 :: ('MESH:D011542', 'Disease') :: ['pseudarthrosis']
@entity612 :: (MESH:D013130,Disease) :: ['spinal stenosis']
