Study shows 15% cumulative ASD rate with instrumented posterior lumbar spine fusion / Un estudio muestra que el 15% de tasa de ASD acumulable con fusión de la columna lumbar posterior instrumentada

http://www.healio.com/spine-surgery/lumbar/news/online/%7B1b6fd88e-8604-455b-9cc6-5f99389ef3be%7D/study-shows-15-cumulative-asd-rate-with-instrumented-posterior-lumbar-spine-fusion

Study shows 15% cumulative ASD rate with instrumented posterior lumbar spine fusion

Bydon M. J Neurosurg Spine. 2014;doi: 10.3171/2013.12.SPINE13789.

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• April 25, 2014

Los investigadores que evaluaron los resultados de 511 pacientes sometidos a fusión lumbar posterior instrumentada por etiologías degenerativas en un lapso de 23 años en una sola institución encontraron una mayor probabilidad de enfermedad del segmento adyacente o ASD que ocurra en pacientes con fusiones lumbares flotantes

Researchers who evaluated results of 511 patients undergoing posterior lumbar instrumented fusion for degenerative etiologies over a 23-year span at a single institution found a greater likelihood for adjacent segment disease or ASD to occur in patients with floating lumbar fusions.

“Because the rostral incidence did not statistically differ between the 2 cohorts, caudal ASD in the floating cohort likely accounts for the increased incidence of ASD. Although the heightened risk of ASD increased the reoperation rate in the floating cohort, the increased rate of postoperative radiculopathy contributed to reoperations in the lumbosacral cohort. Thus, the total reoperation rate is statistically the same,” Bydon and colleagues wrote. “Additional prospective studies may more clearly delineate the potential risk of ASD development as a function of fusion location, as well as long-term outcomes of instrumented posterolateral fusion.” – by Robert Linnehan

"Debido a que la incidencia rostral no difirió estadísticamente entre las 2 cohortes, ASD caudal en la cohorte flotante probablemente explica el aumento de la incidencia de los ASD. Aunque el mayor riesgo de ASD aumentó la tasa de reintervención en la cohorte flotante, el aumento de la tasa de radiculopatía postoperatorio contribuyó a reoperaciones en la cohorte lumbosacra. De este modo, la tasa total de reoperación es estadísticamente igual "Bydon y sus colegas. "Los estudios prospectivos adicionales pueden delinear más claramente el riesgo potencial de desarrollar ASD como una función de la ubicación de la fusión, así como los resultados a largo plazo de la fusión posterolateral instrumentada." - Por Robert Linnehan

Disclosure: Timothy Witham is the recipient of a research grant from Eli Lilly and Company. Ziya Gokaslan is the recipient of research grants from DePuy Spine, AOSpine North America, Medtronic, the Neurosurgery Research and Education Foundation, Integra LifeSciences, and K2M. He receives fellowship support from AOSpine North America. He holds stock in Spinal Kinetics and US Spine. Ali Bydon is the recipient of a research grant from DePuy Spine. He serves on the clinical advisory board of MedImmune, LLC. Daniel Sciubba is the recipient of a research grant from DePuy Spine. He has consulting relationships with Medtronic, NuVasive, Globus, and DePuy.