{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T02:40:02Z","timestamp":1792636802289,"version":"4.5.0"},"reference-count":22,"publisher":"Springer Science and Business Media LLC","issue":"6","license":[{"start":{"date-parts":[[2022,10,4]],"date-time":"2022-10-04T00:00:00Z","timestamp":1664841600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,10,4]],"date-time":"2022-10-04T00:00:00Z","timestamp":1664841600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100002839","name":"Charit\u00e9 - Universit\u00e4tsmedizin Berlin","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100002839","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Neurosurg Rev"],"abstract":"<jats:title>\nAbstract\n<\/jats:title><jats:p>Adjacent segment stenosis can occur after lumbar fusion surgery, leading to significant discomfort and pain. If further surgeries are required, the choice of the operative technique is an individual decision. In patients without over instability, it is still uncertain whether patients with adjacent spinal stenosis should be treated like primary lumbar spinal stenosis via decompressive surgery alone or with decompression and fusion. This is a retrospective analysis with prospective collected data. We included patients with adjacent segment stenosis after lumbar fusion. Patients with spinal deformity and\/or obvious instability and\/or significant neuroforaminal stenosis were excluded. All patients were divided into two groups according to the surgical technique that has been used: (a) treated via microsurgical decompression (MDG), (b) decompression and fusion of the adjacent segment (FG). Treatment decision was at discretion of the surgeon. Primary outcome was the need for further lumbar surgery after 1\u00a0year. In addition, patient reported outcome was measured via numerical rating scale (NRS), SF-36, Oswestry disability Index (ODI), Pittsburgh Sleep Quality Index (PSQI), and General Depression Scale before and after 1\u00a0year after surgery. In a further follow-up, need for additional lumbar surgery was redetermined. Total study population was 37 patients with a median age of 72\u00a0years. A total of 86.1% of patients suffered from a proximal adjacent segment stenosis and most common level was L3\/4 (51.4%). A total of 61.1% of included patients developed adjacent segment stenosis after fusion of one single lumbar segment. Eighteen patients were included in MDG and 19 patients in FG. Both groups benefited from surgical interventions and there was no significant difference concerning pain, pain associated disability, sleeping, life quality, and mood after 1\u00a0year or the need of follow-up surgeries 1\u00a0year after primary fusion (5 in MDG vs. 5 in FG, <jats:italic>p<\/jats:italic>\u2009=\u20090.92) and at the second follow-up with a median time after surgery of 30\u00a0months (6 in MDG vs. 7 in FG, <jats:italic>p<\/jats:italic>\u2009=\u20090.823). Duration of surgery and hospital stay was significant shorter in MDG. There was no difference concerning operative complications rate. Both groups improved significantly in pain associated disability index, pain in motion, and concerning the sleeping quality. The present study indicates that decompression may not be inferior to decompression and fusion in patients suffering from degenerative adjacent segment stenosis without obvious signs of instability, deformation, and neuroforaminal stenosis after lumbar fusion in short-term follow-up. Due to significant shorter time of surgery, a pure microsurgical decompression may be a sufficient alternative to a decompression and fusion, particular regarding old age of this patient cohort.<\/jats:p>","DOI":"10.1007\/s10143-022-01875-4","type":"journal-article","created":{"date-parts":[[2022,10,4]],"date-time":"2022-10-04T14:09:26Z","timestamp":1664892566000},"page":"3739-3748","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Decompression with or without fusion in degenerative adjacent segment stenosis after lumbar fusions"],"prefix":"10.1007","volume":"45","author":[{"given":"Anton","family":"Fr\u00fch","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick","family":"Lei\u00dfa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dimitri","family":"Tkatschenko","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Truckenm\u00fcller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lars","family":"Wessels","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Vajkoczy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon","family":"Bayerl","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,10,4]]},"reference":[{"issue":"11","key":"1875_CR1","doi-asserted-by":"publisher","first-page":"1712","DOI":"10.1016\/j.spinee.2017.06.018","volume":"17","author":"SL de Kunder","year":"2017","unstructured":"de Kunder SL et al (2017) Transforaminal lumbar interbody fusion (TLIF) versus posterior lumbar interbody fusion (PLIF) in lumbar spondylolisthesis: a systematic review and meta-analysis. 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The study was performed in line with the principles of the Declaration of Helsinki.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Human and animal ethics"}},{"value":"Informed consent was obtained from all individual participants included in the study.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}},{"value":"The authors affirm that human research participants provided informed consent for publication of the images in Fig.\u00a0.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":6,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}]}}