SSESSMENT THE SIGNIFICANCE OF THE SAGITTAL BALANCE AND PATHOLOGY OF INTERVERTEBRAL DISCS IN THE DEVELOPMENT OF DEGENERATIVE CHANGES IN THE ADJACENT VERTEBRAL-MOTOR SEGMENTS AFTER LUMBAR SPINE FUSION
This study evaluated 120 patients underwent 360° fusion lumbar surgery. We compare 2 groups: first group include 60 patients with long lumbar fusion (3 and more levels), second group in-clude 60 patients with short lumbar fusion. In the I group symptomatic adjacent segment disease was found in 19 cases during 1 year f/up. There were 14 cases with sagittal imbalance and 5 cases with in-cipient stage of disc degeneration. Summary after 3 years f/up in I group symptomatic adjacent seg-ment disease was diagnosed in 31 cases, in which 17 patients had postop sagittal balance disturbance. In the II group at 1 year f/up 10 patients had adjacent segment disease. Among these cases the preop disc degenerative changes were identified in 8 patients. Sagittal imbalance was found only in 2 cases with symptomatic adjacent segment disease at 1 year f/up. At 3 years f/up the number of patients with symptomatic adjacent segment disease was increased to 14. Patients with postop sagittal imbalance have statistically significant increasing risks of developing symptomatic adjacent segment disease. In the case of a short fixation preoperative degenerative changes are more important in the adjacent segment disease development.