MRI Assessments of Adjacent Disc Degeneration of Lumbar Fusion Group versus Discectomy Group
OBJECTIVE: Using MRI to assess intervertebral disc degeneration at adjacent levels in a group of patients who underwent spinal fusion compared to a group of patients who underwent discectomy. MATERIALS AND METHODS: Fifty-six patients who underwent spinal surgery for lumbar degenerative disease by thecorresponding author and taken minimal 2 years follow-up MRI were included in this study. Of these, we regarded 34 patients of lumbar fusion as study group and 22 discectomy patients as control group. The MRI Thompson classification was used to grade both upper and lower adjacent disc degeneration preoperatively and at the time of the last follow-up by three spine surgeon. We also reviewed the changes of their clinical outcomes according to Thompson grade change. RESULTS: Not only in the 34 fusion group patients, but also in the 22 discectomy group patients, there were significant Thompson grade changes at the upper adjacent levels (p=0.002, p=0.014 respectively). But, there was no significant change at lower adjacent levelsin both 28 fusion and 16 discectomy patients. Thompson grade changesof neither group didn't affect clinical outcomes. CONCLUSIONS: In this study of short-term MRI and radiographic assessments of adjacent disc degeneration comparing patients treated with or without spinal fusion, relatively high rates of adjacent disc degeneration were noted in both groups.
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