scholarly journals Pathoanatomic Risk Factors for Instability and Adjacent Segment Disease in Lumbar Spine: How to Use Topping Off?

2017 ◽  
Vol 2017 ◽  
pp. 1-9 ◽  
Author(s):  
J. Bredow ◽  
L. Löhrer ◽  
J. Oppermann ◽  
M. J. Scheyerer ◽  
R. Sobottke ◽  
...  
Keyword(s):  
Lumbar Spine ◽  
Hybrid System ◽  
Randomized Clinical Trials ◽  
Relevant Literature ◽  
Adjacent Segment Disease ◽  
Adjacent Segment ◽  
Hybrid Instrumentation ◽  
Fascia Thoracolumbalis ◽  
Meta Analyses ◽  
Topping Off

Purpose. The goal of this review is to identify criteria indicating implantation of hybrid system into lumbar spine and to evaluate general benefits of use. Methods. A systematic review of literature was performed using current randomized clinical trials, reviews, and meta-analyses. Data sources included relevant literature of human studies identified through searches of Medline Library until May 2015. Results. Predisposing factors for Adjacent Segment Disease (ASDi) are discussed in literature: laminar horizontalization, insufficiency of fascia thoracolumbalis, facet tropism, and facet sagittalization. Currently there is no evidence for topping off. There are only 12 studies and these have no consistent statements about use of a hybrid system for avoidance of ASDi. Conclusion. Hybrid instrumentation of lumbar spine, either with pedicle-based technique or additional spacer, might possibly prevent ASDi from developing in previously damaged segment adjacent to a fusion. Good clinical data proving effectiveness of this new implant technique is as yet unavailable. Thus, currently one must speak of an unevaluated procedure. Various radiological classifications can assist in making a reliable decision as to whether hybrid instrumentation is an appropriate choice of therapy. Pathoanatomical conditions of facet joints and laminae as well as preservation of sagittal balance must also be considered.

scholarly journals The Interspinous Spacer: A New Posterior Dynamic Stabilization Concept for Prevention of Adjacent Segment Disease

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Antoine Nachanakian ◽  
Antonios El Helou ◽  
Moussa Alaywan
Keyword(s):  
Lumbar Spine ◽  
Preventive Measure ◽  
Radicular Pain ◽  
Dynamic Stabilization ◽  
Adjacent Segment Disease ◽  
Neurogenic Claudication ◽  
Adjacent Segment ◽  
Disability Score ◽  
Interspinous Spacer ◽  
Posterior Dynamic Stabilization

Introduction. Posterior Dynamic stabilization using the interspinous spacer device is a known to be used as an alternative to rigid fusion in neurogenic claudication patients in the absence of macro instability. Actually, it plays an important in the management of adjacent segment disease in previously fused lumbar spine.Materials and Method. We report our experience with posterior dynamic stabilization using an interspinous spacer. 134 cases performed in our institution between September 2008 and August 2012 with different lumbar spine pathologies. The ages of our patients were between 40 and 72 years, with a mean age of 57 years. After almost 4 years of follow up in our patient and comparing their outcome to our previous serious we found that in some case the interspinous distracter has an important role not only in the treatment of adjacent segment disease but also in its prevention.Results and Discussion. Clinical improvement was noted in ISD-treated patients, with high satisfaction rate. At first, radicular pain improves with more than 3/10 reduction of the mean score on visual analog scale (VAS). In addition, disability score as well as disc height and lordotic angle showed major improvement at 3 to 6 months post operatively. And, no adjacent segment disease was reported in the patient operated with interspinous spacer.Conclusion. The interspinous spacer is safe and efficient modality to be used not only as a treatment of adjacent segment disease but also as a preventive measure in patients necessitating rigid fusion.

Minimally invasive options for surgical management of adjacent segment disease of the lumbar spine

2018 ◽  
Vol 66 (3) ◽  
pp. 755 ◽  
Author(s):  
MazdaK Turel ◽  
MenaG Kerolus ◽  
BrianT David ◽  
RichardG Fessler
Keyword(s):  
Lumbar Spine ◽  
Minimally Invasive ◽  
Surgical Management ◽  
Adjacent Segment Disease ◽  
Adjacent Segment

A Biomechanical Analysis of Lateral Interbody Construct and Supplemental Fixation in Adjacent-Segment Disease of the Lumbar Spine

2019 ◽  
Vol 128 ◽  
pp. e694-e699
Author(s):  
M. Craig McMains ◽  
Nikhil Jain ◽  
Azeem Tariq Malik ◽  
Emily Cerier ◽  
Alan S. Litsky ◽  
...  
Keyword(s):  
Lumbar Spine ◽  
Biomechanical Analysis ◽  
Adjacent Segment Disease ◽  
Adjacent Segment ◽  
Supplemental Fixation ◽  
Lateral Interbody

scholarly journals Etiology-Based Classification of Adjacent Segment Disease Following Lumbar Spine Fusion

2019 ◽  
Vol 16 (2) ◽  
pp. 130-136
Author(s):  
Philip K. Louie ◽  
Garrett K. Harada ◽  
Arash J. Sayari ◽  
Benjamin C. Mayo ◽  
Jannat M. Khan ◽  
...  
Keyword(s):  
Lumbar Spine ◽  
Spine Fusion ◽  
Adjacent Segment Disease ◽  
Adjacent Segment ◽  
Lumbar Spine Fusion

scholarly journals Topping-Off Technology versus Posterior Lumbar Interbody Fusion in the Treatment of Lumbar Disc Herniation: A Meta-Analysis

2020 ◽  
Vol 2020 ◽  
pp. 1-10 ◽  
Author(s):  
Wei Wang ◽  
Xiangyao Sun ◽  
Tongtong Zhang ◽  
Siyuan Sun ◽  
Chao Kong ◽  
...  
Keyword(s):  
Interbody Fusion ◽  
Posterior Lumbar Interbody Fusion ◽  
Adjacent Segment Disease ◽  
Adjacent Segment ◽  
Complication Rates ◽  
Lumbar Interbody Fusion ◽  
Significant Difference ◽  
Duration Of Surgery ◽  
Reoperation Rates ◽  
Topping Off

The treatment effects of topping-off technique were still controversial. This study compared all available data on postoperative clinical and radiographic outcomes of topping-off technique and posterior lumbar interbody fusion (PLIF). PubMed, EMBASE, and Cochrane were systematically reviewed. Variations included radiographical adjacent segment disease (RASD), clinical adjacent segment disease (CASD), global lumbar lordosis (GLL), visual analogue scale (VAS) of back (VAS-B) and leg (VAS-L), Oswestry disability index (ODI), Japanese Orthopaedic Association (JOA) score, duration of surgery, estimated blood loss (EBL), reoperation rates, and complication rates. Sixteen studies, including 1372 cases, were selected for the analysis. Rates of proximal RASD (P=0.0004), distal RASD (P=0.03), postoperative VAS-B (P=0.0001), postoperative VAS-L (P=0.02), EBL (P=0.007), and duration of surgery (P=0.02) were significantly lower in topping-off group than those in PLIF group. Postoperative ODI after 3 years (P=0.04) in the topping-off group was significantly less than that in the PLIF group. There was no significant difference in the rates of CASD (P=0.06), postoperative GLL (P=0.14), postoperative ODI within 3 years (P=0.24), and postoperative JOA (P=0.70) and in reoperation rates (P=0.32) and complication rates (P=0.27) between topping-off group and PLIF. The results confirmed that topping-off technique could effectively prevent ASDs after lumbar internal fixation. However, this effect is effective in preventing RASD. Topping-off technique is more effective in improving the subjective feelings of patients rather than objective motor functions compared with PLIF. With the development of surgical techniques, both topping-off technique and PLIF are safe.

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