STUDY DESIGN: A retrospective long-term follow-up study. OBJECTIVE: Evaluate the fate of L5-S1 disc analyzing subsequent @entity1797 and associated risk factors for @entity528 at minimum 5-year follow-up (average 9-year follow-up). SUMMARY OF BACKGROUND DATA: Two previous studies reported the results of @entity85 fusions terminating at L5 with minimum 2-year follow-up only. METHODS: Thirty-one consecutive @entity1 with an average age of 45 years (range, 20-62 years) were fused from the thoracic spine to L5 and were evaluated at a mean follow-up of 9.4 years (range, 5-20.1 year). @entity1 were evaluated before surgery, after surgery, and latest follow-up with radiographs and Scoliosis Research Society @entity1 Questionnaire-24 scores. @entity1797 using validated radiographic Weiner grades. Grade 0 to 1 discs were "healthy" and Grade 2 to 3 were degenerated. @entity1 with "healthy" discs preoperative that subsequently degenerated were designated @entity528 ( @entity528 ). RESULTS: Two out of 31 @entity1 had preoperative advanced @entity528 of the L5-S1 disc (Weiner grade 2-3). Three additional @entity1 had an early revision to the sacrum secondary to sagittal imbalance not thought to be related to @entity528 . Twenty-six out of 31 @entity1 were assessed as "healthy discs" preoperative (Weiner grade 0-1) and were evaluated for @entity528 . By latest follow-up, L5-S1 @entity528 developed in 18 of these 26 @entity1 (69%). Risk factors for the development of @entity528 included long fusions extending into the upper thoracic spine down to L5 (P = 0.02) and having a circumferential lumbar fusion (P = 0.02). Although preoperative sagittal balance was not significantly different between the "healthy" and @entity528 group, sagittal balance at follow-up was: C7 plumb >5 cm in 67% of @entity528 @entity1 and only 13% of "healthy" disc @entity1 (P = 0.009). There was a trend toward inferior Scoliosis Research Society @entity1 Questionnaire-24 @entity158 scores at follow-up in @entity528 @entity1 (average score 4.1 vs. 3.4, P = 0.13). Eleven out of 30 @entity1 (35%) had subsequent spinal surgery with 7 of 31 (23%) having extension of their fusion to the sacrum. An additional 6 of 31 (19%) were considered for extension to the sacrum but comorbidities precluded surgery (3 @entity1 ) or the @entity1 declined further surgery (3 @entity1 ). CONCLUSION: Advanced L5-S1 @entity3603 developed in 69% of @entity85 @entity1 after long fusions to L5 with 5 to 15 year follow-up. @entity528 frequently results in significant positive sagittal balance at a minimum 5-year follow-up. Long fusions to the upper thoracic spine down to L5 and circumferential fusion may further promote subsequent L5-S1 @entity1797 .

XXXX arthrodesis stopping at L5: fate of the L5-S1 disc, minimum 5-year follow-up.

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients', 'Patient'] @entity1797 :: ('MESH:D055959', 'Disease') :: ['Disc degeneration', 'disc degeneration'] @entity3603 :: ('MESH:C562924', 'Disease') :: ['DDD'] @entity158 :: ('MESH:D010146', 'Disease') :: ['pain'] @entity85 :: ('MESH:D009140', 'Disease') :: ['deformity', 'long deformity'] @entity528 :: ('MESH:D009410', 'Disease') :: ['subsequent advanced degeneration', 'SAD', 'degeneration']
@entity85 :: (MESH:D009140,Disease) :: ['Thoracolumbar deformity']
