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dc.contributor.authorToivonen, Leevi A.
dc.contributor.authorMäntymäki, Heikki
dc.contributor.authorHäkkinen, Arja
dc.contributor.authorKautiainen, Hannu
dc.contributor.authorNeva, Marko H.
dc.date.accessioned2022-01-26T07:33:07Z
dc.date.available2022-01-26T07:33:07Z
dc.date.issued2022
dc.identifier.citationToivonen, L. A., Mäntymäki, H., Häkkinen, A., Kautiainen, H., & Neva, M. H. (2022). Isthmic Spondylolisthesis is Associated With Less Revisions for Adjacent Segment Disease After Lumbar Spine Fusion Than Degenerative Spinal Conditions : A 10-Year Follow-Up Study. <i>Spine</i>, <i>47</i>(4), 303-308. <a href="https://doi.org/10.1097/BRS.0000000000004242" target="_blank">https://doi.org/10.1097/BRS.0000000000004242</a>
dc.identifier.otherCONVID_101365585
dc.identifier.urihttps://jyx.jyu.fi/handle/123456789/79529
dc.description.abstractObjective: We aim to compare the rate of revisions for adjacent segment disease (ASD) after lumbar spine fusion (LSF) surgery between patients with isthmic spondylolisthesis (IS) and degenerative lumbar spine disorders (DLSD). Summary of Background Data: ASD is a major reason for late reoperations after LSF surgery. Several risk factors are linked to the progression of ASD, but the understanding of the underlying mechanisms is imperfect. If IS infrequently becomes complicated with ASD, it would emphasize the role of the ongoing degenerative process in spine in the development of ASD. Methods: 365 consecutive patients that underwent elective LSF surgery were followed up for an average of 9.7 years. Surgical indications were classified into 1) IS (n=64), 2) DLSD (spinal stenosis with or without spondylolisthesis) (n=222), and 3) other reasons (deformities, postoperative conditions after decompression surgery, posttraumatic conditions) (n=79). All spinal reoperations were collected from hospital records. Rates of revisions for ASD were determined using Kaplan-Meier methods. Results: Altogether, 65 (17.8%) patients were reoperated for ASD. The incidences of revisions for ASD in subgroups were 1) 4.8% (95% CI: 1.6 to 22.1%); 2) 20.5% (95% CI: 15.6 to 26.7%); 3) 20.6% (95% CI: 12.9 to 31.9%). After adjusting the groups by age, sex, fusion length, and the level of the caudal end of fusion, when comparing with IS group, the other groups had significantly higher hazard ratios (HR) for the revision for ASD [2) HR (95% CI) 3.92 (1.10 to 13.96), p=0.035], [3) HR (95% CI) of 4.27 (1.11 to 15.54), p=0.036]. Conclusions: Among patients with IS, the incidence of revisions for ASD was less than a 4th of that with DLSD. Efforts to prevent the acceleration of the degenerative process at the adjacent level of fusion are most important with DLSD.en
dc.format.mimetypeapplication/pdf
dc.language.isoeng
dc.publisherLippincott Williams & Wilkins
dc.relation.ispartofseriesSpine
dc.rightsCC BY-NC-ND 4.0
dc.subject.otherlumbar spine fusion
dc.subject.otheradjacent segment disease
dc.subject.otheradjacent segment pathology
dc.subject.otherrevisions
dc.subject.otheristhmic spondylolisthesis
dc.subject.otherdegenerative lumbar spine disorders
dc.subject.otherdegenerative spinal disorders
dc.subject.otherspinal stenosis
dc.subject.otherdegenerative spondylolisthesis
dc.titleIsthmic Spondylolisthesis is Associated With Less Revisions for Adjacent Segment Disease After Lumbar Spine Fusion Than Degenerative Spinal Conditions : A 10-Year Follow-Up Study
dc.typearticle
dc.identifier.urnURN:NBN:fi:jyu-202201261300
dc.contributor.laitosLiikuntatieteellinen tiedekuntafi
dc.contributor.laitosFaculty of Sport and Health Sciencesen
dc.contributor.oppiaineFysioterapiafi
dc.contributor.oppiainePhysiotherapyen
dc.type.urihttp://purl.org/eprint/type/JournalArticle
dc.type.coarhttp://purl.org/coar/resource_type/c_2df8fbb1
dc.description.reviewstatuspeerReviewed
dc.format.pagerange303-308
dc.relation.issn0362-2436
dc.relation.numberinseries4
dc.relation.volume47
dc.type.versionpublishedVersion
dc.rights.copyright© 2021 The Author(s). Published by Wolters Kluwer Health, Inc.
dc.rights.accesslevelopenAccessfi
dc.subject.ysoleikkaushoito
dc.subject.ysohoitotulokset
dc.subject.ysolanneranka
dc.subject.ysonikamavälilevyn rappeuma
dc.subject.ysoselkäsairaudet
dc.subject.ysospondylolisteesi
dc.format.contentfulltext
jyx.subject.urihttp://www.yso.fi/onto/yso/p842
jyx.subject.urihttp://www.yso.fi/onto/yso/p25941
jyx.subject.urihttp://www.yso.fi/onto/yso/p5598
jyx.subject.urihttp://www.yso.fi/onto/yso/p10543
jyx.subject.urihttp://www.yso.fi/onto/yso/p2499
jyx.subject.urihttp://www.yso.fi/onto/yso/p13944
dc.rights.urlhttps://creativecommons.org/licenses/by-nc-nd/4.0/
dc.relation.doi10.1097/BRS.0000000000004242
jyx.fundinginformationThe Competitive State Financing of the Expert Responsibility Area of Tampere University Hospital funds were received in support of this work.
dc.type.okmA1


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