[Utility of ligamentoplasty for the prevention of adjacent segment disease above 360 degree arthrodesis in degenerative lumbar spondylosis. Preliminary report].

BACKGROUND

Ligamentoplasty is a dynamic stabilization method used to treat lumbar stenosis and resect lumbar herniated discs with good results. The objective of this paper is to report preliminary results of the utility of ligamentoplasty to prevent adjacent segment disease above the arthrodesis.

MATERIAL AND

METHODS

Two groups of patients with degenerative lumbar spondylolisthesis who underwent circumferential arthrodesis. In 23 patients a dynamic stabilization system was placed in the segment above (group L), while this system was not used in 35 patients (group S). Degeneration and disease of the segment above were assessed. The statistical analysis was done with the SPSS 15.0 software.

RESULTS

At the one-year follow-up, the incidence rate of adjacent segment degeneration was 11% for group L and 0% for group S; at the two-year follow-up it was 13% in both groups; at three years, 0% for group L and 19% for group S; at four years, 25% for group L and 0% for group S. At five years, 50% for group L and 0% for group S. Clinically significant radiculopathy occurred in two patients five years after surgery, one of whom also had adjacent segment disease.

CONCLUSIONS

Based on the follow-up, at this moment it is not possible to show the utility of dynamic stabilization through ligamentoplasty to avoid adjacent segment disease above the arthrodesis.