70세 이상 요추부 유합술 후 인접 분절 질환 환자의 수술 및 신경중재 치료의 효과 비교

초록

Objective The goal of this study is to compare the effect of surgical and neuro-intervention treatments for elderly patients who suffer from symptomatic adjacent segment disease (ASD) subsequent to lumbar fusion surgery. Methods Patients over 70 years old who were treated for symptomatic ASD at our institute with at least 1 year follow up has been included retrospectively. Total 30 patients were included; 20 patients underwent revision surgery (surgical group) and 10 patients were treated with nerve block and radiofrequency neurotomy (neuro-intervention group). Clinical demographic data were collected and low back pain was scored with visual analogue scale (VAS) at time point of pre-operation (Pre-op), post-operation day 7 (POD7), and post-operation year 1 (POY1). Results Age, sex, hypertension, diabete mellitus, and pre-op VAS (4.00±1.12 vs 3.70±0.95; mean±SD) showed no significant difference between surgical and neuro-intervention groups (p>0.05). The VAS score decreased significantly after treatment at POD7 (1.90±0.79, 1.80±1.03) and POY1 (2.75±1.21, 2.10±1.20) for both groups respectively (p<0.05). ΔPre-POD7 and ΔPre-POY1 VAS showed no significant difference between two groups (2.10±1.45 vs 1.90±0.99, 1.25±1.71 vs 1.60±1.43 respectively; p>0.05). Conclusion In lumbar ASD patients over 70 years old, surgical and neuro-intervention treatments both decreased low back pain and had no significant difference between two groups. Neuro-intervention treatment could be considered initially in case of low back pain dominant elderly ASD patients after lumbar fusion surgery.

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