There is a debate regarding the distal fusion level for @entity179 . Whether a healthy L5-S1 motion segment should be included or not in the fusion remains controversial. The purpose of this study was to determine the optimal indication for the fusion to the sacrum, and to compare the results of distal fusion to L5 versus the sacrum in the long instrumented fusion for @entity179 . A total of 45 @entity1 who had undergone long instrumentation and fusion for @entity179 were evaluated with a minimum 2 year follow-up. Twenty-four @entity1 (mean age 63.6) underwent fusion to L5 and 21 @entity1 (mean age 65.6) underwent fusion to the sacrum. Supplemental interbody fusion was performed in 12 @entity1 in the L5 group and eleven @entity1 in the sacrum group. The number of levels fused was 6.08 segments (range 4-8) in the L5 group and 6.09 (range 4-9) in the sacrum group. Intraoperative @entity190 (2,754 ml versus 2,938 ml) and operative time (220 min versus 229 min) were similar in both groups. The Cobb angle changed from 24.7 degrees before surgery to 6.8 degrees after surgery in the L5 group, and from 22.8 degrees to 7.7 degrees in the sacrum group without statistical difference. Correction of lumbar @entity1515 was statistically better in the sacrum group (P = 0.03). Less correction of lumbar @entity1515 in the L5 group seemed to be associated with subsequent advanced L5-S1 @entity1797 . The change of coronal and sagittal imbalance was not different in both groups. Subsequent advanced L5-S1 @entity1797 occurred in 58% of the @entity1 in the L5 group. Symptomatic @entity1347 at L5-S1 developed in five @entity1 . Interestingly, the development of @entity1347 was not related to the preoperative grade of @entity1797 , which proved minimal degeneration in the five @entity1 . In the L5 group, there were nine @entity1 of complications at L5-S1 segment, including @entity1347 at L5-S1 and loosening of L5 screws. Seven of the nine @entity1 showed preoperative sagittal imbalance and/or @entity2649 , which might be risk factors of complications at L5-S1. For the @entity1 with sagittal imbalance and @entity2649 , L5-S1 should be included in the fusion even if L5-S1 disc was minimal degeneration.

Arthrodesis to L5 versus S1 in long instrumentation and fusion for XXXX .

@entity1 :: ('9606', 'Species') :: ['patients'] @entity1797 :: ('MESH:D055959', 'Disease') :: ['disc degeneration'] @entity190 :: ('MESH:D006473', 'Disease') :: ['blood loss'] @entity1347 :: ('MESH:C537775', 'Disease') :: ['adjacent segment disease'] @entity2649 :: ('MESH:C563613', 'Disease') :: ['lumbar hypolordosis'] @entity1515 :: ('MESH:D008141', 'Disease') :: ['lordosis'] @entity179 :: ('MESH:D019636', 'Disease') :: ['degenerative lumbar scoliosis']
@entity179 :: (MESH:D019636,Disease) :: ['degenerative lumbar scoliosis']
