{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T01:42:30Z","timestamp":1788399750601,"version":"build-2803163510"},"reference-count":26,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[1999,4]]},"abstract":"<jats:p content-type=\"fine-print\"><jats:italic>Object.<\/jats:italic> The authors performed a retrospective analysis of 125 consecutive patients in whom instrumentation was placed to promote lumbar fusion for the treatment of degenerative instability. All procedures were performed by a single surgeon. The authors sought to determine the risk factors for next-segment degeneration after lumbar spinal fusion with rigid instrumentation.<\/jats:p>\n<jats:p content-type=\"fine-print\"><jats:italic>Methods.<\/jats:italic> Thirty-one of 125 fusion procedures were performed in women who were postmenopausal. A total of 18 of 125 patients developed symptomatic next-segment degeneration at a previously asymptomatic level; 15 were postmenopausal women. Data were obtained in patients with next-segment failure based on radiographic studies, neurological assessment, demographic factors, and sequential follow-up examinations. The mean follow-up period for this group was 44.8 months. All women were postmenopausal, and 53% received biphosphonate drugs and calcium supplementation preoperatively for osteopenia. Twenty percent of all patients with next-segment failure were cigarette smokers. Next-segment diseases included spondylolisthesis (39%), spinal canal stenosis due to disc herniation and\/or facet hypertrophy (33%), stress fracture of the adjacent vertebral body (28%), and scoliosis (17%). Patients frequently had more than one degenerative process at the next segment.<\/jats:p>\n<jats:p content-type=\"fine-print\"><jats:italic>Conclusions.<\/jats:italic> The risk of adjacent-segment failure is clearly higher for patients in whom lumbar fusion with rigid instrumentation is performed to treat degenerative instability. This risk appears to be especially high in postmenopausal women.<\/jats:p>","DOI":"10.3171\/spi.1999.90.2.0163","type":"journal-article","created":{"date-parts":[[2009,5,7]],"date-time":"2009-05-07T15:46:08Z","timestamp":1241711168000},"page":"163-169","source":"Crossref","is-referenced-by-count":89,"title":["Risk factors for adjacent-segment failure following lumbar fixation with rigid instrumentation for degenerative instability"],"prefix":"10.3171","volume":"90","author":[{"given":"Shahin","family":"Etebar","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David W.","family":"Cahill","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1","series-title":"J Spinal Disord","first-page":"464","article-title":"Postfusion instability at the adjacent segments after rigid pedicle screw fixation for degenerative lumbar spinal disorders.","volume":"8","author":"Aota","year":"1995"},{"key":"b2","series-title":"Clin Orthop Rel Res","first-page":"130","article-title":"Post-laminectomy and post-fusion stenosis of the lumbar spine.","volume":"115","author":"Brodsky","year":"1976"},{"key":"b3","series-title":"Spine","doi-asserted-by":"publisher","first-page":"447","DOI":"10.1097\/00007632-198904000-00022","article-title":"Segmental (\u201cfloating\u201d) lumbar spine fusions.","volume":"14","author":"Brodsky","year":"1989"},{"key":"b4","series-title":"J Bone Joint Surg (Br)","first-page":"720","article-title":"Acquired spondylosis after spinal fusion.","volume":"66","author":"Brunet","year":"1984"},{"key":"b5","series-title":"J Surg Res","doi-asserted-by":"publisher","first-page":"61","DOI":"10.1016\/0022-4804(78)90159-2","article-title":"The effect of spinal fusion on the collagen and proteoglycans of the canine intervertebral disc.","volume":"25","author":"Bushell","year":"1978"},{"key":"b6","series-title":"J Orthop Res","doi-asserted-by":"publisher","first-page":"277","DOI":"10.1002\/jor.1100030304","article-title":"Effects of spinal fusion on proteoglycans of the canine intervertebral disc.","volume":"3","author":"Cole","year":"1985"},{"key":"b7","series-title":"J Orthop Res","doi-asserted-by":"publisher","first-page":"337","DOI":"10.1002\/jor.1100050305","article-title":"The response of canine intervertebral disc to immobilization produced by spinal arthrodesis is dependent on constitutional factors.","volume":"5","author":"Cole","year":"1987"},{"key":"b8","series-title":"J Bone Joint Surg (Am)","doi-asserted-by":"publisher","first-page":"897","DOI":"10.2106\/00004623-196850050-00003","article-title":"Motion of the lumbosacral spine after laminectomy and spine fusion: correlation of the motion and the result.","volume":"50","author":"Froning","year":"1968"},{"key":"b9","series-title":"Spine","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1097\/00007632-197803000-00002","article-title":"Failed lumbar disc surgery requiring second operation: a long-term follow-up study.","volume":"3","author":"Frymoyer","year":"1978"},{"key":"b10","series-title":"J Spinal Disord","first-page":"99","article-title":"Effect of immobilization and configuration on lumbar adjacent segment biomechanics.","volume":"6","author":"Ha","year":"1993"},{"key":"b11","series-title":"J Bone Joint Surg (Am)","doi-asserted-by":"publisher","first-page":"1159","DOI":"10.2106\/00004623-196345060-00003","article-title":"Acquired spondylosis as a sequel to spine fusion.","volume":"45","author":"Harris","year":"1963"},{"key":"b12","series-title":"Spine","doi-asserted-by":"publisher","first-page":"268","DOI":"10.1097\/00007632-198404000-00008","article-title":"The effects of internal fixation on the articular cartilage of the unfused canine facet joint cartilage.","volume":"9","author":"Kahanovitz","year":"1984"},{"key":"b13","series-title":"Clin Orthop Rel Res","first-page":"204","article-title":"The effect of internal fixation without arthrodesis on human facet joint cartilage.","volume":"189","author":"Kahanovitz","year":"1984"},{"key":"b14","series-title":"Spine","doi-asserted-by":"publisher","first-page":"375","DOI":"10.1097\/00007632-198803000-00029","article-title":"Accelerated degeneration of the segment adjacent to a lumbar fusion.","volume":"13","author":"Lee","year":"1988"},{"key":"b15","series-title":"Spine","doi-asserted-by":"publisher","first-page":"574","DOI":"10.1097\/00007632-198409000-00007","article-title":"Lumbosacral spinal fusion: a biomechanical study.","volume":"9","author":"Lee","year":"1984"},{"key":"b16","series-title":"Spine","first-page":"97","article-title":"Long-term follow-up of lower lumbar fusion patients.","volume":"2","author":"Lehmann","year":"1987"},{"key":"b17","series-title":"Spine","doi-asserted-by":"publisher","first-page":"996","DOI":"10.1097\/00007632-198712000-00010","article-title":"The effect on the lumbosacral spine of long spinal fusion for idiopathic scoliosis: a minimum 10-year follow-up.","volume":"12","author":"Luk","year":"1987"},{"key":"b18","series-title":"Spine","doi-asserted-by":"publisher","first-page":"2471","DOI":"10.1097\/00007632-199312000-00017","article-title":"The effects of immobilization of long segments of the spine on the adjacent and distal facet force and lumbosacral motion.","volume":"18","author":"Nagata","year":"1993"},{"key":"b19","series-title":"Spine","doi-asserted-by":"publisher","first-page":"667","DOI":"10.1097\/00007632-199703150-00019","article-title":"Threaded titanium cages for lumbar interbody fusions.","volume":"22","author":"Ray","year":"1997"},{"key":"b20","series-title":"Clin Orthop Rel Res","first-page":"7","article-title":"Internal fixation of the lumbar spine with pedicle screw plating.","volume":"203","author":"Roy-Camille","year":"1986"},{"key":"b21","series-title":"Spine","doi-asserted-by":"publisher","first-page":"970","DOI":"10.1097\/00007632-199604150-00013","article-title":"Lumbar motion segment pathology adjacent to thoracolumbar, lumbar and lumbosacral fusions.","volume":"21","author":"Schlegel","year":"1996"},{"key":"b22","series-title":"J Bone Joint Surg (Am)","first-page":"400","article-title":"Pseudoarthrosis following spine fusion.","volume":"31","author":"Thompson","year":"1997"},{"key":"b23","series-title":"Clin Orthop Rel Res","first-page":"80","article-title":"Posterolateral fusion in pseudoarthrosis and posterior element defects of the lumbosacral spine.","volume":"35","author":"Watkins","year":"1964"},{"key":"b24","series-title":"J Bone Joint Surg (Am)","doi-asserted-by":"publisher","first-page":"1179","DOI":"10.2106\/00004623-199173080-00006","article-title":"Results of spinal arthrodesis with pedicle screw-plate fixators.","volume":"73","author":"West","year":"1991"},{"key":"b25","series-title":"Spine","doi-asserted-by":"publisher","first-page":"557","DOI":"10.1097\/00007632-198409000-00005","article-title":"Mechanism of facet load transmission as a hypothesis for low back pain.","volume":"9","author":"Yang","year":"1984"},{"key":"b26","series-title":"Spine","doi-asserted-by":"publisher","first-page":"937","DOI":"10.1097\/00007632-198611000-00014","article-title":"Biomechanics of lumbosacral spinal fusion in combined compression-torsion loads.","volume":"11","author":"Yang","year":"1986"}],"container-title":["Journal of Neurosurgery: Spine"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/90\/2\/article-p163.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-spine\/90\/2\/article-p163.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-spine\/90\/2\/article-p163.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,4,16]],"date-time":"2023-04-16T00:29:39Z","timestamp":1681604979000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/90\/2\/article-p163.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1999,4]]},"references-count":26,"journal-issue":{"issue":"2"},"URL":"https:\/\/doi.org\/10.3171\/spi.1999.90.2.0163","relation":{},"ISSN":["1547-5654"],"issn-type":[{"value":"1547-5654","type":"print"}],"subject":[],"published":{"date-parts":[[1999,4]]}}}