Turkish Neurosurgery 2020 , Vol 30 , Num 6
The Effect of Distal Fusion Level on Functional and Radiographic Parameters in Degenerative Spine Following Long Posterior Instrumentation and Fusion
Semih Kivanc OLGUNER1,Mustafa CELIKTAS2,Ali ARSLAN1,Ismail ISTEMEN1,Yurdal GEZERCAN1,Ali Ihsan OKTEN1,Mahir GULSEN2
1Adana City Training Research Hospital, Department of Neurosurgery, Adana, Turkey
2Ortopedia Hospital, Department of Spine Surgery, Adana, Turkey
DOI : 10.5137/1019-5149.JTN.28554-19.3 AIM: To investigate the effect of distal fusion level on radiographic parameters and functional outcome in patients with degenerative spine disease who undergo long posterior fusion with instrumentation.

MATERIAL and METHODS: This study included 78 adult patients aged>60 years who underwent long posterior fusion (>6 levels) for spinal deformity with a minimum 2-year follow-up. The patients were divided into two groups based on distal fusion level (L5 group and iliac group). Spinopelvic parameters, including lumbar lordosis (LL) and sagittal vertical axis (SVA), were evaluated. Functional outcome was evaluated with the pain visual analog scale (VAS) and the Oswestry Disability Index (ODI) questionnaire. Correlations between clinical and radiographic parameters were calculated statistically.

RESULTS: In the L5 group, the mean SVA and LL significantly improved after surgery (p=0.025 and 0.008, respectively). Similarly, the SVA and LL also improved significantly in the iliac group (p=0.002 and 0.001, respectively). In both groups, lumbar VAS, leg VAS and ODI scores significantly improved (p<0.001). The change in ODI score was significantly greater in the iliac group than the L5 group (p=0.013).

CONCLUSION: Although patients did not achieve the desired optimal spinal saggital balance, both L5 and iliac groups showed significant improvement in VAS and ODI scores. The iliac group showed slightly better improvement in ODI score. Keywords : Clinical outcome, Distal fusion level, Long posterior instrumentation

Corresponding author : Semih Kivanc OLGUNER, kivanc3olguner@hotmail.com