• Gabriel Flores-Milan, César Carballo Cuello, Elliot Pressman, Gersham Rainone, Jenna Marek, Adolfo Viloria Hidalgo, Alexander Haas, Erik Hayman, and Puya Alikhani.
• World Neurosurg. 2024 Sep 13.

IntroductionRadiographic 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 IRB approval, 120 total patients who underwent 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.Results120 total patients were included. 73.3% of patients had percutaneous screws, and 11.7% had open. 13 patients underwent LLIF with ACR. The mean LL was 50.1± 12.9, PI was 52.8 ± 11.2, SS was 33.6± 9.2, PT was 18.1 ± 6.8, and SVA was 6.8 mm ± 30.5. 24 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% CI=1.029-1.171), as was ACR (p<0.001, OR=9.667, and 95% CI=2.669-35.09).ConclusionHigher 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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