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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/advagg_css\/css__ce2QY63WIanKyr8eSq7eavr1XQRRmFD6ZSmwpyJi8lM__zXwFqpqmxrZOXXcd_TpBQpjuELbmIP9wBR5UuTDWAO4__YJWWMMdfCJuAFm5cUEp88OsodhO3ZA-2lzRfoBsSlk4.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\n            \u003Cp id=\u0022p-1\u0022\u003EThis article presents the results of a prospective comparative study\u2014Effect of Superior Adjacent Segment Degeneration after Lumbar Posterolateral Fusion Using Two Different Pedicle Screw Insertion Positions With Nine-Year Minimum Follow-Up\u2014of patients with low-grade isthmic spondylolisthesis, which assessed the effect of different pedicle screw insertion positions on adjacent segment degeneration.\u003C\/p\u003E\n         \u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003ESpine Conditions\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EOrthopaedics Clinical Trials\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EOrthopaedic Procedures\u003C\/li\u003E\u003C\/ul\u003E\u003Cul class=\u0022kwd-group clinical-trial\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003ESpine Conditions\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EOrthopaedics Clinical Trials\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EOrthopaedics\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EOrthopaedic Procedures\u003C\/li\u003E\u003C\/ul\u003E\u003Cdiv class=\u0022section\u0022 id=\u0022sec-1\u0022\u003E\n         \n         \u003Cp id=\u0022p-2\u0022\u003EHao Dingjun, MD, Xi\u0027an Jiaotong University, Xi\u0027an, China, presented the results of a prospective comparative study\u2014Effect of Superior Adjacent Segment Degeneration after Lumbar Posterolateral Fusion Using Two Different Pedicle Screw Insertion Positions With Nine-Year Minimum Follow-Up [Yan L et al. \u003Cem\u003ESpine\u003C\/em\u003E. 2014]\u2014of patients with low-grade isthmic spondylolisthesis (IS), which assessed the effect of different pedicle screw insertion positions on adjacent segment degeneration (ASD).\u003C\/p\u003E\n         \u003Cp id=\u0022p-3\u0022\u003EFrom January 1999 to December 2003, 210 patients who underwent posterolateral fusion for low-grade IS were randomized to 2 groups according to different pedicle screw insertion positions. In group A (n = 102), the method by Du and Zhao [\u003Cem\u003EChin J Spine Spinal Cord\u003C\/em\u003E. 2001] was used to place the pedicle screw insertion. In group B (n = 108), the method by Magerl and colleagues \u003Cem\u003E[Clin Orthop Relat Res.\u003C\/em\u003E 1984] was used, which needs more lateral and steeper angles for insertion.\u003C\/p\u003E\n         \u003Cp id=\u0022p-4\u0022\u003EInclusion criteria included patients who were aged 18 to 55 years and had single-level IS (grade 1 or 2), persistent low back pain for \u0026gt; 6 months, and loss of quality of life with neurologic claudication. The follow-up period was at least 108 months. Patients were excluded from the study if they had undergone revision surgery, had \u2265 grade 3 spondylolisthesis or concomitant scoliosis of \u0026gt; 15\u00b0, or had an implant removed during the follow-up period.\u003C\/p\u003E\n         \u003Cp id=\u0022p-5\u0022\u003EOf the 210 patients, 178 (84.7%) were available for at least a 9-year clinical and radiologic follow-up. Of these, 87 (85.3%) were patients in group A, and 91 (84.3%) were in group B.\u003C\/p\u003E\n         \u003Cp id=\u0022p-6\u0022\u003EPatient characteristics between the 2 groups were comparable. The majority of the patients were women in both groups (about 53%), with an average age of 46 years, a mean body mass index of about 24.3 kg\/m\u003Csup\u003E2\u003C\/sup\u003E, and a fusion level at L5-S1 (about 78%).\u003C\/p\u003E\n         \u003Cp id=\u0022p-7\u0022\u003EThe study found significant differences (all \u003Cem\u003EP\u003C\/em\u003E \u0026lt; .001) between the pre- and postoperative measures for all patients, using the Oswestry Disability Index (ODI) and the visual analog scale (VAS) for back and leg pain. In terms of postoperative ODI and VAS scores, no differences were found between the ASD and non-ASD groups nor between group A and group B. However, when the ODI scores were compared in terms of ASD, significantly more patients in group A had ASD compared with group B (28.6% vs 15.7%; \u003Cem\u003EP\u003C\/em\u003E \u0026lt; .001).\u003C\/p\u003E\n         \u003Cp id=\u0022p-8\u0022\u003EAccording to Dr Dingjun, these findings show that the position of the pedicle screws during lumbar fusion surgery is closely related to superior ASD and that reducing the superior ASD can be done by inserting the pedicle screw in a position farther from the facet joint surface.\u003C\/p\u003E\n      \u003C\/div\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2015 MD Conference Express\u00ae\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/14\/50\/17.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nzltc2\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}