MR assessment of the adjacent segment degeneration after discography

OBJECTIVE: It recently reported that intradiscal procedures during provocative discography damaged the punctured disc and accelerated disc degeneration in lumbar spine. We aimed to assess whether discography affect the acceleration of disc degeneration at the adjacent levels of lumbar fusion. MATERIALS AND METHODS: A total of 113 discs of 58 patients (ALIF 19, PLF 22, decompression 17) who had undergone a spine surgery for lumbar degenerative disease with preoperative provocative discography were included in this study. Each patients had both preoperative and a minimum of 5-year follow-up MRI. Subject discs were grouped as adjacent discs of fusion (62 discs), and non-fusion controls (51 discs). The progression of the adjacent disc degeneration depending on provocative discography was assessed with preoperative and repeated MRI by three observers, three times each. Logistic regression was conducted to analyze the risk factors for ASD. Statistical analysis was carried out using statistical package for social sciences (SPSS) version 12.0 software (SPSS Inc, Chicago,Illinois). A P < .05 was considered significant. RESULTS: The mean follow-up duration was 86.0±28.7 months (60~192 months). Demographic variables were homogeneous between the two groups. The progression of disc degeneration was not different between the adjacent levels of fusion (P=0.446) and nonfusion control (P=0.613), regardless of whether concordant pain had been provocated or not. Preoperative diagnosis, type of surgery, gender, age, follow-up duration, and Modic change were not relevant for ASD. Logistic regression revealed that the only significant factor for ASD was the preexisting disc degeneration (OR 2.649, 95% CI 1.607-4.367). Pfirrman grade 3 was the most vulnerable stage for ASD. CONCLUSION: Pain provocation on discography did not predict the progression of disc degeneration at the adjacent levels of surgery. Constitutional factors such as preexisting disc degeneration should be considered as an etiology of ASD.

Author dc:creator

• 현, 환섭

Contributors dc:contributor

• 전, 창훈
• 대학원 의학과
• 201124143

• 요추
• 척추 수술 인접 분절의 퇴행성 변화
• MRI
• lumbar spine
• adjacent disc degeneration

Language dc:language

ko

Identifier

http://dcoll.ajou.ac.kr:9080/dcollection/jsp/common/DcLoOrgPer.jsp?sItemId=000000013928
000000013928

OAI identifier oai:identifier

oai:repository.ajou.ac.kr:201003/8642