INCIDENCE AND RISK FACTORS OF ADJECENT LUMBAR SEGMENT DEGENERATIVE DISEASE FOLLOVING DORSAL DECOMPRESSION-STABILIZING SURGERY
To analyze the prevalence and risk factors for the adjacent segment degeneration s (ADS)/ adjacent segment degenerative disease (ASDd) development in patients undergoing dorsal decompression-stabilizing interventions. The study included medical records of 164 patients (97 men, 67 women, the average age was 54.2±10.4 years) which in the period from January 2016 to January 2019 on the basis of the Department of Neurosurgery of the Regional Clinical Hospital (Krasnoyarsk, Russian Federation) performed dorsal decompression-stabilizing interventions for lumbar spine degenerative diseases. Individual patient characteristics, surgical parameters, and instrumental data were evaluated. Signs of ADS/ASDd were verified in 11 (6.7%) patients, while in all cases they were noted at the level of the overlying segment. The construction of a logistic regression model clearly demonstrated the significant effect of a high body mass index (more than 25 kg/m2), a high degree of degeneration of adjacent intervertebral discs (grade III-IV by Pfirrmann C. classification, and a low value of adjacent segments angulation (less than 10.50) at risk of developing ADS/ASDd in patients who have undergone dorsal decompression-stabilizing interventions. In patients before dorsal decompression-stabilizing interventions and identifying risk factors for the formation of ADS/ASDd to prevent the development of adverse clinical outcomes and repeated surgical interventions, it is advisable to either involve an overlying level in rigid stabilization or use dynamic fixation devices for prophylactic purposes.