Could the Topping-Off Technique Be the Preventive Strategy against Adjacent Segment Disease after Pedicle Screw-Based Fusion in Lumbar Degenerative Diseases? A Systematic Review
Table 5
Adjacent segment disease and implant-related complications in hybrid stabilization device and interspinous process device.
Authors, years
Symptomatic ASD at index level or supra-adjacent level
Radiographic ASD at index level or supra-adjacent level
(1) Listhesis (2) Disc collapse (3) ↑segmental range of motion (ROM) (4) >grade II of modified UCLA grade
Spinous process fr.: no Implant failure: NA
0
NA
NA: not available. Numbers: occurrence of patients numbers. Pre-op: preoperative. Radiographic ASD defined as one of the following criteria in X-ray: (1) disc height decrease ≦ 50%; (2) listhesis ≧ 3 mm (neutral position); (3) disc angle decrease (at flexion) ≧5°. ASD: adjacent segment disease, pts: patients, PSs: pedicle screws, DD: disc degeneration, DIAM: Device for Intervertebral Assisted Motion, f/u: follow-up, and fr.: fracture. 1 pt. suffered clinically symptomatic dislocation of dynamic pedicle screws and needed revision surgery of implant removal at 26 months f/u and was excluded in the study.