Abstract
The problems arising at the levels above or below a previous successful fusion are well known. The aim of this study was to determine the incidence of junctional disk degeneration and/or stenosis and to attempt to establish preventative measures.
Between July 1993 and December 2000, a single surgeon performed lumbosacral fusions on 938 patients. The primary fusion was subsequently extended in 26 men and 16 women (2.8%). The mean age of patients at the time of the second fusion was 52 years. The mean time from the primary to a second procedure was three years. Initial data showed that seven patients had mild to moderate degeneration of the disc and/or facet joints above the level of intended fusion. No other risk factors were identified.
At 2.8%, it would appear that extension of a fusion is necessary less often than anticipated. The need for extension may have been prevented in seven patients had the primary fusion been extended.
The abstracts were prepared by Professor M. B. E. Sweet. Correspondence should be addressed to him at The Department of Orthopaedic Surgery, Medical School, University of Witwatersrand, 7 York Road, Parktown, Johannesburg, 2193 South Africa
