{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,2]],"date-time":"2026-01-02T17:29:18Z","timestamp":1767374958705,"version":"3.41.0"},"reference-count":24,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:sec><jats:title>OBJECTIVE<\/jats:title><jats:p>In this study, the authors\u2019 aim was to investigate whether obesity affects surgery rates for adjacent-segment degeneration (ASD) after transforaminal lumbar interbody fusion (TLIF) for spondylolisthesis.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>Patients who underwent single-level TLIF for spondylolisthesis at the University of California, San Francisco, from 2006 to 2016 were retrospectively analyzed. Inclusion criteria were a minimum 2-year follow-up, single-level TLIF, and degenerative lumbar spondylolisthesis. Exclusion criteria were trauma, tumor, infection, multilevel fusions, non-TLIF fusions, or less than a 2-year follow-up. Patient demographic data were collected, and an analysis of spinopelvic parameters was performed. The patients were divided into two groups: mismatched, or pelvic incidence (PI) minus lumbar lordosis (LL) \u2265 10\u00b0; and balanced, or PI-LL &lt; 10\u00b0. Within the two groups, the patients were further classified by BMI (&lt; 30 and \u2265 30 kg\/m<jats:sup>2<\/jats:sup>). Patients were then evaluated for surgery for ASD, matched by BMI and PI-LL parameters.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>A total of 190 patients met inclusion criteria (72 males and 118 females, mean age 59.57 \u00b1 12.39 years). The average follow-up was 40.21 \u00b1 20.42 months (range 24\u2013135 months). In total, 24 patients (12.63% of 190) underwent surgery for ASD. Within the entire cohort, 82 patients were in the mismatched group, and 108 patients were in the balanced group. Within the mismatched group, adjacent-segment surgeries occurred at the following rates: BMI &lt; 30 kg\/m<jats:sup>2<\/jats:sup>, 2.1% (1\/48); and BMI \u2265 30 kg\/m<jats:sup>2<\/jats:sup>, 17.6% (6\/34). Significant differences were seen between patients with BMI \u2265 30 and BMI &lt; 30 (p = 0.018). A receiver operating characteristic curve for BMI as a predictor for ASD was established, with an AUC of 0.69 (95% CI 0.49\u20130.90). The optimal BMI cutoff value determined by the Youden index is 29.95 (sensitivity 0.857; specificity 0.627). However, in the balanced PI-LL group (108\/190 patients), there was no difference in surgery rates for ASD among the patients with different BMIs (p &gt; 0.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>In patients who have a PI-LL mismatch, obesity may be associated with an increased risk of surgery for ASD after TLIF, but in obese patients without PI-LL mismatch, this association was not observed.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2020.6.spine20159","type":"journal-article","created":{"date-parts":[[2020,10,9]],"date-time":"2020-10-09T07:20:07Z","timestamp":1602228007000},"page":"83-88","source":"Crossref","is-referenced-by-count":5,"title":["Obesity may be associated with adjacent-segment degeneration after single-level transforaminal lumbar interbody fusion in spinopelvic-mismatched patients with a minimum 2-year follow-up"],"prefix":"10.3171","volume":"34","author":[{"given":"Ping-Guo","family":"Duan","sequence":"first","affiliation":[{"name":"Departments of Neurological Surgery and"},{"name":"Department of Orthopaedic Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Praveen V.","family":"Mummaneni","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Minghao","family":"Wang","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew K.","family":"Chan","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bo","family":"Li","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rory","family":"Mayer","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sigurd H.","family":"Berven","sequence":"additional","affiliation":[{"name":"Orthopaedic Surgery, University of California, San Francisco, California; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dean","family":"Chou","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery and"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"key":"b1","series-title":"Clin Neurol Neurosurg","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1016\/j.clineuro.2017.02.020","article-title":"Adjacent segment disease after instrumented fusion for adult lumbar spondylolisthesis: Incidence and risk factors","volume":"156","author":"Zhong ZM","year":"2017","unstructured":"Zhong ZM, Deviren V, Tay B,  Adjacent segment disease after instrumented fusion for adult lumbar spondylolisthesis: Incidence and risk factors. 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