Could the Topping-Off Technique Be the Preventive Strategy against Adjacent Segment Disease after Pedicle Screw-Based Fusion in Lumbar Degenerative Diseases? A Systematic Review

Table 5

Adjacent segment disease and implant-related complications in hybrid stabilization device and interspinous process device.

Authors,; years	Symptomatic ASD at; index level or; supra-adjacent level	Radiographic ASD at; index level or; supra-adjacent level	Criteria for; radiographic ASD	Dynamic implant-; related complications	Reasons for revision
					Symptomatic; ASD	Implant; failure
Formica et al. [13], 2015	0 pts: index level; 0 pts: supra-adjacent level	0 pts: index level; 0 pts: supra-adjacent level	NA	No	No	No
Putzier et al. [14], 2010	0 pts: index level; 0 pts: supra-adjacent level	2 pts.: index level; 1: fusion, 1: instability; 2 pts: supra-adjacent level; 2: progressive DD	(1) Fusion; (2) Disc degeneration Modic > 1; (3) Facet arthritis, Fujiwara > Gr. 1; (4) <25% pre-op disc height; (5) Instability signs such as traction spurs	1 pt: dynamic PSs; dislocation at 26 months; Removed implant; (the pt was excluded in the study)	No	1^+
Imagama et al. [15], 2009	0 pts: index level; 0 pts: supra-adjacent level	10 pts: index level (7 pts by MRI); (3 pts diagnosed by X-ray); 5 pts: supra-adjacent level (2 pts by MRI); (3 pts diagnosed by X-ray)	(1) DD (Pfirrmann) progression ≧1 grade; (2) Spinal stenosis progression ≧ 1 grade	No	No	No
Lu et al. [16], 2015	3 pts: index level; 0 pts: supra-adjacent level	3 pts: index level; 0 pts: supra-adjacent level	(1) Anterolisthesis; (2) Retrolisthesis due to hypermobility on; flexion/extension; (3) Loss of disc height and sclerosis along; endplate (DD)	Spinous process fr.: no; Implant failure: no	1	No
Lee et al. [17], 2013	2 pts: index level; NA: supra-adjacent level	6 pts: index level; NA: supra-adjacent level	(1) Collapsed disk space (Pfirrmann Gr. V); (2) Spondylolisthesis (translation ≧3 mm); (3) Proximal junctional kyphosis Cobb angle ≧10°(4) Compression fr. at adjacent segments	Spinous process fr.: no; Implant failure: NA	2	NA
Korovessis et al. [18], 2009	0 pts: index level; 0 pt: supra-adjacent level	1 pt: index level; 1 pt: supra-adjacent level	(1) Listhesis; (2) Disc collapse; (3) ↑segmental range of motion (ROM); (4) >grade II of modified UCLA grade	Spinous process fr.: no; Implant failure: NA	0	NA

NA: not available. Numbers: occurrence of patients numbers. Pre-op: preoperative.
Radiographic ASD defined as one of the following criteria in X-ray: (1) disc height decrease ≦ 50%; (2) listhesis ≧ 3 mm (neutral position); (3) disc angle decrease (at flexion) ≧5°.
ASD: adjacent segment disease, pts: patients, PSs: pedicle screws, DD: disc degeneration, DIAM: Device for Intervertebral Assisted Motion, f/u: follow-up, and fr.: fracture. 1 pt. suffered clinically symptomatic dislocation of dynamic pedicle screws and needed revision surgery of implant removal at 26 months f/u and was excluded in the study.