Effect of the Posterior Ligamentous Complex on the Adjacent Segments Degeneration After Lumbar Surgery

Study Overview
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Brief Summary
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To investigate whether destroying the adjacent posterior ligamentous complex (PLC) has an effect on adjacent segment degeneration (ASD) after L5/S1 posterior lumbar interbody fusion (PLIF)

Detailed Description
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Purpose: To investigate whether destroying the adjacent posterior ligamentous complex (PLC) has an effect on adjacent segment degeneration (ASD) after L5/S1 posterior lumbar interbody fusion (PLIF). Methods: This retrospective study was performed in patients who received L5/S1 PLIF with pedicle screw instrumentation for lumbar spinal stenosis with or without isthmic spondylolisthesis. They were divided into the total laminectomy group, which had destruction of the PLC of the adjacent segment, or partial laminectomy group, which did not. Vertebral slip, osteophytes, disk height, and range of motion were examined by plain radiography, and thickness of the ligamentum flavum (LF) and anteroposterior diameters of the lumbar vertebral body and spinal canal were assessed by magnetic resonance imaging (MRI). Disc degeneration and spinal stenosis on MRI scans were categorized. The incidence of ASD and clinical outcome were compared between the groups.

Official Title
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Effect of the Posterior Ligamentous Complex on the Adjacent Segments Degeneration After Lumbar Surgery

Conditions
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Lumbar Spinal Stenosis

Intervention / Treatment
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* Procedure: total laminectomy


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: typical clinical symptoms such as disabling low back or leg pain with or without neurological symptoms, intermittent claudication, with refractory to ≥6 months of strict conservative treatment; and L5/S1 single-level PLIF with pedicle screw instrumentation. Exclusion Criteria: previous spine surgery, acute spinal fracture, infection, and tumor.

Ages Eligible for Study
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Minimum Age: 25 Years
Maximum Age: 75 Years

Sexes Eligible for Study
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All

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| group 1<br>patients in this group destructed the posterior ligamentous complex of the adjacent segment | Procedure: total laminectomy<br>* Total laminectomy removes the posterior ligamentous complex (PLC) at the fusion and superior levels.<br>|
| group 2<br>patients in this group did not destruct the of the posterior ligamentous complex of the adjacent segment | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| the Incidences of adjacent segment degeneration | the Incidences of adjacent segment degeneration | From the end of treatment to more than 8 years | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Adjacent Segment Degeneration, lumbar posterior ligamentous complex, posterior lumbar interbody fusion