The Analysis Of Influence Factors Of Lumbar Adjacent Segment Degeneration After Lumbar Interbody Fusion

【Objective】To observe the influence factors,pathogenesis and preventative measuresof lumbar adjacent segment degeneration after lumbar interbody fusion.【Method】By bilateral Cohort Studies method,120patients who hospitalized a upperfirst-class hospital during March2002to April2012were cured by lumbar interbodyfusion,and they were accepted a postoperative follow-up.2case were lost at last.The118patients were accepted the measurement of lumbar X-ray photograph,they weredivided into lumbar adjacent segment degeneration group and normal group accordingto the result of X-ray.At last the probable influence factors were analysed by one-wayANOVA and analysis of covariance.【Result】The study showed that the rate of the lumbar adjacent intervertebral spacedegeneration after lumbar interbody fusion was79.66%.The one-way ANOVAanalysis showed that the difference between the degenerated group and normal groupwas statistically significant(P<0.05) as is concerned to the mode of decompression,thenumber of decompression segment,the number of internal fixationsegment,However,the number of cage and cross were no statistically significant(P＞0.05).The further analysis of covariance was used to analyze the mode ofdecompression,the number of decompression segment,the number of internal fixationsegment between two groups.And the results showed as follows:when it comes to themode of decompression between two groups, the difference among the nonedecompression,fenestration laminectomy and Semi laminectomy was no statisticallysignificantt(P＞0.05),while the difference between the none decompression and wholeLaminectomy was obviously statistically significant(P<0.05),however the differencebetween Semi laminectomyand whole Laminectomy was obviously statisticallysignificant(P<0.05).when it concerned to the number of decompression segmentbetween two groups,the difference among none decompression,two segmentaldecompression,three segmental decompression and four segmental decompressionwas statistically significant(P<0.05),while the difference between the none decompression and one segmental decompression was no statistically significant(P＞0.05).when it refered to the number of internal fixation segment between twogroups,the difference between none internal fixation and one segmental internalfixation was obviously statistically significant (P<0.05),while the difference amongthe none internal fixation,two segmental internal fixation,three segmental internalfixation and four segmental internal fixation was no statistically significant(P＞0.05).【Conclusion】A high rate of lumbar adjacent segment degeneration in patients afterlumbar interbody fusion.The mode of decompression,the number of decompressionsegment,the number of internal fixation were the influence factors of lumbar adjacentsegment degeneration after lumbar interbody fusion,However,whether the cage wereinserted to the lumbar intervertebral space and the cross were installed or not,the rateof lumbar adjacent segment degeneration were constant.