Skip to main content
SpringerLink
Log in

Influence of the preoperative L5S1 disc state on lateral L2 to L5 fusion’s outcomes at an average follow-up of 3,5 years (minimum 2 years)

  • Original Article
  • Published:
European Spine Journal Aims and scope Submit manuscript

Abstract

Introduction

The impact of pre-existing degeneration of a disc underlying a lumbar arthrodesis via lateral approach on long-term clinical outcome has, to our knowledge, not been studied. When performing arthrodesis between L2 and L5, its extension to L5S1 is challenging because it imposes a different surgical approach. Therefore, surgeon’s temptation is to not include L5S1 in the fusion even in case of discopathy. Our objective was to study the influence of the preoperative L5S1 status on the clinical outcome of lumbar lateral interbody fusion (LLIF) using a pre-psoatic approach between L2 and L5 with a minimum follow-up of 2 years.

Material and methods

Patients who underwent LLIF from L2 to L5 between 2015 and 2020 were included in our study. We studied VAS, ODI, and global clinical outcome before surgery and at last follow-up. The L5–S1 disc was radiologically studied in preoperative imaging. Patients were included in two groups (A “with” and B :without” L5–S1 disc degeneration) to compare the clinical outcomes at last follow-up. Our primary objective was to evaluate the rate of L5–S1 disc revision surgery at last follow-up.

Results

102 patients were included. 2 required L5–S1 disc surgery following overlying arthrodesis. Our results showed a significant improvement in the patients' clinical outcomes at the last follow-up (p < 0.0001). We did not find any significant difference on clinical criteria between groups A & B.

Conclusion

A preop L5S1 disc degeneration does not seem to impact the final clinical outcomes after lumbar lateral interbody fusion at a minimal two years F.U. It should not be systematically involved in an overlying fusion.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

Data availability

The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request.

References

  1. Guigui P, Wodecki P, Bizot P, Lambert P, Chaumeil G, Deburge A (2000) Influence à long terme de l’arthrodèse associée sur les niveaux adjacents dans le traitement des sténoses lombaires [Long-term influence of associated arthrodesis on adjacent segments in the treatment of lumbar stenosis: a series of 127 cases with 9-year follow-up]. Rev Chir Orthop Reparatrice Appar Mot 86(6):546–557

    CAS  PubMed  Google Scholar 

  2. Gillet P (2003) The fate of the adjacent motion segments after lumbar fusion. Spine 28:338–345

    Article  Google Scholar 

  3. Mannion AF, Leivseth G, Brox JI, Fritzell P, Hagg O, Fairbank JC (2014) ISSLS prize winner: long-term follow-up suggests spinal fusion is associated with increased adjacent segment disc degeneration but without influence on clinical outcome: results of a combined follow-up from 4 randomized controlled trials. Spine 39(17):1373–1783

    Article  PubMed  Google Scholar 

  4. Ghiselli G, Wang JC, Hsu WK, Dawson EG (2003) L5–S1 segment survivorship and clinical outcome analysis after L4–L5 isolated fusion. Spine 28(12):1275–1280

    Article  PubMed  Google Scholar 

  5. Xia XP, Chen HL, Cheng HB (2013) Prevalence of adjacent segment degeneration after spine surgery: a systematic review and meta-analysis. Spine 38(7):597–608. https://doi.org/10.1097/BRS.0b013e318273a2ea

    Article  PubMed  Google Scholar 

  6. Wai EK, Santos ERG, Morcom RA, Fraser RD (2006) Magnetic resonance imaging 20 years after anterior lumbar interbody fusion. Spine 31:1952–1956

    Article  PubMed  Google Scholar 

  7. Min JH, Jang JS, Jung B, Lee HY, Choi WC, Shim CS et al (2008) The clinical characteristics and risk factors for the adjacent segment degeneration in instrumented lumbar fusion. J Spinal Disord Tech 21(5):305–309

    Article  PubMed  Google Scholar 

  8. Hashimoto K, Aizawa T, Kanno H, Itoi E (2019) Adjacent segment degeneration after fusion spinal surgery: a systematic review. Int Orthop 43:987–993

    Article  PubMed  Google Scholar 

  9. Pan A, Hai Y, Yang J, Zhou L, Chen X, Guo H (2016) Adjacent segment degeneration after lumbar spinal fusion compared with motion-preservation procedures: a meta-analysis. Eur Spine J 25:1522–1532

    Article  PubMed  Google Scholar 

  10. Scemama C, Magrino B, Gillet P, Guigui P (2016) Risk of adjacent-segment disease requiring surgery after short lumbar fusion: results of the French Spine surgery society series. J Neurosurg Spine 25:46–51

    Article  PubMed  Google Scholar 

  11. Miyakoshi N, Abe E, Shimada Y, Okuyama K, Suzuki T, Sato K (2000) Outcome of one-level posterior lumbar interbody fusion for spondylolisthesis and postoperative intervertebral disc degeneration adjacent to the fusion. Spine 25:1837–1842

    Article  CAS  PubMed  Google Scholar 

  12. Sears WR, Sergides IG, Kazemi N, Smith M, White GJ, Osburg B (2011) Incidence and prevalence of surgery at segments adjacent to a previous posterior lumbar arthrodesis. Spine J 11(1):11–20

    Article  PubMed  Google Scholar 

  13. Cheh G, Bridwell KH, Lenke LG, Buchowski JM, Daubs MD, Kim Y et al (2007) Adjacent segment disease followinglumbar/thoracolumbar fusion with pedicle screw instrumentation: a minimum 5-year follow-up. Spine 32(20):2253–2257

    Article  PubMed  Google Scholar 

  14. Liao JC, Chen WJ, Chen LH, Niu CC (2009) Outcome of the L5–S1 segment after posterior instrumented spinal surgery in degenerative lumbar diseases. Chang Gung Med J 32(1):81–8

    PubMed  Google Scholar 

  15. Park JY, Chin DK, Cho YE (2009) Accelerated L5–S1 segment degeneration after spinal fusion on and above L4–5: minimum 4-year follow-up results. J Korean Neurosurg Soc 45(2):81–84

    Article  PubMed  PubMed Central  Google Scholar 

  16. Pfirrmann CW, Metzdorf A, Zanetti M, Hodler J, Boos N (2001) Mag- netic resonance classification of lumbar intervertebral disc degene- ration. Spine 26:1873–1878

    Article  CAS  PubMed  Google Scholar 

  17. Modic MT, Masaryk TJ, Ross JS, Carter JR (1988) Imaging of degenerative disk disease. Radiology 168:177–186. https://doi.org/10.1148/radiology.168.1.3289089

    Article  CAS  PubMed  Google Scholar 

  18. Chao Li, Qing He, Tang Y, Ruan D (2015) The fate of adjacent segments with pre-existing degeneration after lumbar posterolateral fusion: the influence of degenerative grading. Eur Spine J 24:2468–2473. https://doi.org/10.1007/s00586-015-3921-2

    Article  Google Scholar 

  19. Nakashima H, Kawakami N, Tsuji T et al (2015) Adjacent segment disease after posterior lumbar interbody fusion. Spine 40(14):E831–E834. https://doi.org/10.1097/BRS.0000000000000917

    Article  PubMed  Google Scholar 

  20. Lee CS, Hwang CJ, Lee SW et al (2009) Risk factors for adjacent segment disease after lumbar fusion. Eur Spine J 18(11):1637–1643. https://doi.org/10.1007/s00586-009-1060-3

    Article  PubMed  PubMed Central  Google Scholar 

  21. Lai PL, Chen LH, Niu CC, Fu TS, Chen WJ (2004) Relation between laminectomy and development of adjacent segment instability after lumbar fusion with pedicle fixation. Spine 2004(29):2527–2532. https://doi.org/10.1097/01.brs.0000144408.02918.20

    Article  Google Scholar 

  22. Rothrock RJ, McNeill IT, Yaeger K, Oermann EK, Cho SK, Caridi JM (2018) Lumbar lordosis correction with interbody fusion: systematic literature review and analysis. World Neurosurg 118:21–31. https://doi.org/10.1016/j.wneu.2018.06.216

    Article  PubMed  Google Scholar 

  23. Pesenti S, Lafage R, Stein D, Elysee JC, Lenke LG, Schwab FJ et al (2018) The amount of proximal lumbar lordosis is related to pelvic incidence. Clin Orthop 476:1603–1611. https://doi.org/10.1097/CORR.0000000000000380

    Article  PubMed  PubMed Central  Google Scholar 

  24. Rothrock RJ, McNeill IT, Yaeger K, Oermann EK, Cho SK, Caridi JM (2018) Lumbar lordosis correction with interbody fusion: systematic literature review and analysis. World Neurosurg 118:21–31. https://doi.org/10.1016/j.wneu.2018.06.216

    Article  PubMed  Google Scholar 

  25. Liu H, Wu W, Li Y, Liu J, Yang K, Chen Y (2013) Protective effects of preserving the posterior complex on the development of adjacent-segment degeneration after lumbar fusion: clinical article. J Neurosurg Spine 19(2):201–206

    Article  PubMed  Google Scholar 

Download references

Funding

No funding was required for this study.

Author information

Authors and Affiliations

  1. Institut du Rachis Parisien, Clinique Geoffroy-Saint-Hilaire, 59, Rue Geoffroy-Saint-Hilaire, 75005, Paris, Ile-de-France, France

    P. Lavantes, A. Poignard, J. Delambre, S. Queinnec, R. Arvieu & J. Allain

  2. Institut Parisien du Dos, Clinique Geoffroy-Saint-Hilaire, 59, Rue Geoffroy-Saint-Hilaire, 75005, Paris, Ile-de-France, France

    T. Dufour

Authors
  1. P. Lavantes
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. A. Poignard
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. J. Delambre
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. S. Queinnec
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. T. Dufour
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. R. Arvieu
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. J. Allain
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

JA is the overall study principal investigator. LP, AR, PA, DJ, DT, QS, and JA participated in the study conception and design, contributed to the writing of the study protocol, drafting, and editing of this manuscript and read and approved the final manuscript.

Corresponding author

Correspondence to P. Lavantes.

Ethics declarations

Conflicts of interest

Pr POIGNARD Alexandre, Dr DELAMBRE Jerome and Dr LAVANTES Paul have no relevant financial or non-financial interests to disclose. Dr DUFOUR Thierry is consultant for and has some royalties from ZimVie. Dr QUEINNEC Steffen is consultant for STRYKER compagny and NEO compagny, also shareholder and proxy for the NEO compagny. Dr ARVIEU Robin is consultant for NEO company. Pr ALLAIN Jerome has consultant for STRYKER compagny and NEO company and MEDTRONIC and has some royalties from ZimVie.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Lavantes, P., Poignard, A., Delambre, J. et al. Influence of the preoperative L5S1 disc state on lateral L2 to L5 fusion’s outcomes at an average follow-up of 3,5 years (minimum 2 years). Eur Spine J 32, 2344–2349 (2023). https://doi.org/10.1007/s00586-023-07771-9

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00586-023-07771-9

Keywords

Search

Navigation