Objective: The information available on the association between transforaminal lumbar interbody fusion (TLIF) surgery and adjacent segment degeneration (ASD) in lumbar spinal stenosis (LSS) patients is extremely limited. To explore the risk factors involved in the development of ASD after decompression and fusion surgery for LSS. Materials and Methods: This study subjects were patients who underwent lumbar posterior segmental instrumentation and spinal decompression surgery for degenerative LSS, in L4-5 or L5-S1, during 2010-2015. These patients were classified into two groups based on their stage of ASD development. The diagnosis of ASD was based on magnetic resonance imaging findings. The study groups were compared to determine the risk factors for ASD. Results: A total of 162 patients (68 men, 94 women) of a mean age 60.76±6.4 years (age range: 37-89 years) were evaluated. The mean followup period for these patients was 67.42±5.6 months. Decompression surgery with TLIF was applied to 67 patients, while decompression surgery without TLIF was applied to 95 patients. Overall, ASD developed in 40 patients (24.7%). The type of stenosis was found to be a risk factor for ASD. Conclusion: Our results suggested that, although instrumentation and fusion applied to the surgical area caused an increase in stress and degeneration in the adjacent segment owing to immobilisation and stiffness in this area, the rate of increase did not rise with TLIF cage. Furthermore, the type of stenosis was determined to be a risk factor for ASD in our study.
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