THE OUTCOME OF SPARING S1 ARTHRODESIS IN THE MANAGEMENT OF LUMBOSACRAL DEGENERATIVE DISEASES | ||
| Egyptian Journal of Orthopedic Research | ||
| Article 1, Volume 5, Issue 1, March 2025, Pages 1-9 PDF (845.54 K) | ||
| Document Type: Original articles: include clinical trials, interventional research, Basic researches and clinically relevant laboratory investigations | ||
| DOI: 10.21608/ejor.2024.418178 | ||
| Authors | ||
| Ahmed Kamal Abdelhameid; Khaled Nasser Fadle; Bahaa Ghareeb Hassanin | ||
| Neurosurgery dept., Sohag Faculty of Medicine, Sohag, Egypt | ||
| Abstract | ||
| Background: In patients with a completely healthy disc at L5-S1 disc or minimal degenerated disc and planned for short segment fixation with one or two levels above the sacrum, sparing S1 arthrodesis will not carry a high risk of adjacent segment or the need for another surgery with an extension of the fixation to the S1. In comparison to long segment fixation especially in elderly patients the fusion should extend to involve the sacrum from the start due to the high possibility of adjacent segments disease. Through the last three decades, the decision to take S1 in the fixation segment versus stopping at L5 in the management of lumbar degenerative spine diseases has still been debated. Aim of the study: The purpose of this study was to evaluate the clinical outcome of the S1 sparing arthrodesis in the management of lumbar spine dege- nerative disease with above-level short- segment fusion procedures. Patients and methods: Under a complete ethical committee (family education and consent) twenty-six patients with degenerative lumbosacral spine diseases were introduced to our Neurospine unit in Sohag University Hospital Department of Neurosurgery from January 2020 to January 2024. All patients underwent preoperative evaluation with complete neurological examination, lumbosacral dynamic X-ray, lumbosacral MRI spine, and CT lumbosacral spine if needed. Oswestry disability index (also known as Oswestry Low Back Pain Disability Questionnaire) and Visual analogue pain scale (VAS) were used in this study for all patients to evaluate the post-operative outcome. Results: Twenty-six patients were operated with degenerative lumbosacral spine diseases with a predominance of male ratio. Our patient’s ages ranged from 33–67 years with a mean of 58.36 ±5.96 years. In our study, the L4-5 grade II spondylolisthesis was more predominant accounting for 8 cases. Mild degenerative L5- S1 disc was found in 12 cases however, the remaining 14 cases were normal L5-S1 disc. Back pain was the main complaint for all our patients and we use the Oswestry Back Pain Disability Scale and VAS for pre- and postoperative assessment. Sciatic pain presented in 20 cases, and only 3 cases presented with partial foot drop. Conclusion: Sparing the extension of the fixation to the sacrum in the management of lumbosacral degenerative diseases especially in those with mild or near normal L5-S1 disc will preserve the biomechanics of the lumbosacral junction with low incidence of pseudoarthrosis and sacroiliac joint degenerative changes. | ||
| Keywords | ||
| Arthrodesis; Lumbosacral; S1 | ||
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