• Gabriel Flores-Milan, Carballo CuelloCésarCDepartment of Neurosurgery and Brain Repair, University of South Florida, Morsani College of Medicine, Tampa, Florida, USA., Elliot Pressman, Gersham Rainone, Jenna Marek, Viloria HidalgoAdolfoADepartment of Neurosurgery and Brain Repair, University of South Florida, Morsani College of Medicine, Tampa, Florida, USA., Alexander Haas, Erik Hayman, and Puya Alikhani.
• Department of Neurosurgery and Brain Repair, University of South Florida, Morsani College of Medicine, Tampa, Florida, USA.
• World Neurosurg. 2024 Dec 1; 192: e56e63e56-e63.

BackgroundRadiographic adjacent segment disease (ASD) ranges from 10% to 84%, depending on technique. Occurrence of symptomatic ASD is lower, with a range of 1.9% to 13%. ASD can be very debilitating and necessitate further procedures, leading to high morbidity. Herein, we explore the occurrence of adjacent segment disease when performing anterior column release in lateral interbody fusion.MethodsAfter institutional review board approval, 120 total patients who underwent lateral lumbar interbody fusion (LLIF) at our facility from 2013 to 2020 were retrospectively reviewed, allowing for a minimum of 3 years for follow-up time. Surgical variables and spinopelvic parameters were measured and collected by our team. Statistical measures of significance were calculated using IBM SPSS Statistics Version 29.ResultsOne hundred twenty total patients were included. 73.3% of patients had percutaneous screws, and 11.7% had open. Thirteen patients underwent LLIF with anterior column release (ACR). The mean lumbar lordosis (LL) was 50.1 ± 12.9, pelvic incidence (PI) was 52.8 ± 11.2, sacral slope was 33.6 ± 9.2, pelvic tilt was 18.1 ± 6.8, and sagittal vertical axis was 6.8 mm ± 30.5.Twenty four total patients had ASD after LLIF. In univariable analysis, ACR (P < 0.001) and PI-LL Mismatch (P < 0.035) were risk factors for developing ASD. In multivariable analysis, greater PI-LL mismatch was predictive of ASD (P < 0.005, OR = 1.097, and 95% confidence interval = 1.029-1.171), as was ACR (P < 0.001, OR = 9.667, and 95% confidence interval = 2.669-35.09).ConclusionsHigher PI-LL mismatch after lumbar interbody fusion, and performance of an ACR during LLIF increased the likelihood of developing symptomatic ASD in our patients. Considering ACR to achieve the goal of correcting spinopelvic parameters should be carefully evaluated when undertaking a lateral approach.Copyright © 2024 Elsevier Inc. All rights reserved.

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