OBJECTIVE: We studied the incidence of lombar AS surgically treated and the factors associated with it. METHOD: Retrospective cross sectional study. RESULTS: We found 50 surgeries for AS performed in 1662 cases, 530 in the lumbar spine, incidence: 9.4%. Average age: 62 years. Main symptoms: radicular claudication (80%). Radiographs prior to the first surgery level that will suffer AS: UCLA 1 (45%) and 2 (27%), lordosis pre-revision: 36° average and 44° post-revision. Pre-revision: IP 55°, VP 26° and PS 29° and postoperative IP 56°, VP 22° and PS 34°. Sagittal imbalance pre-revision 60% and postoperative 27%, coronal balance recovered in both cases. MRI before the first intervention was 83% with Pfirmann IV. AS level: 38% L3-L4, L5-S1: 26%. AS types: lumbar stenosis worsened by monosegmental antero-listhesis in 20 and retro-listhesis in 14; multisegmental stenosis 4, disc herniation 4, crush fracture 4, stenosis without listhesis 4. Period between the 2 surgeries: on average 6 years. CONCLUSION: An incidence of 9.4% of reoperation due to adjacent syndrome makes this disease an important long-term problem, forcing the surgeon to take all the possible steps to avoid this. With the results of this retrospective study we could only say that the segments more likely to develop AS are those with Pfirmann IV on MRI and that the relation VP (20%) and PS (80%) pre and post-operative should be taken into account to return to the spinal column perfect mechanical condition. Prospective clinical studies are needed for more conclusive results.
Syndrome; Spinal diseases, Surgery; Radiography
