We investigated if applying the Transition system (Globus Medical Inc., Audubon, PA, USA) as topping off can prevent Adjacent Segment Degeneration (ASD) and if rate of ASD is increased if instrumentation stopped at the apex of the Lumbar Lordosis (LL). We enrolled 99 consecutive patients in a retrospective study who have been operated by instrumented fusion of the lumbar spine. Thirty patients were treated by topping of (Group 1), 69 patients received the standard procedure (Group 2). 18 patients of group 1 (60%) and 38 patients of group 2 (55%) developed ASD. The difference was not significant (P>0.05). In 17 patients (17%) instrumentation stopped at apex of LL. 14/17 patients (82%) developed an ASD. This influence was significant (P<0.05). Instrumented fusion of the lumbar spine should not stop at the apex of the lumbar curve. Topping off by hybrid dynamic fixation does not reduce the rate of ASD.
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机译：我们调查了是否应用过渡系统（Globus Medical Inc.，美国宾夕法尼亚州奥杜邦）作为补充可以预防相邻节段退变（ASD），并且如果在腰椎前凸（LL）的顶点停止了器械，是否可以提高ASD的发生率。我们在一项回顾性研究中招募了99名连续性腰椎脊柱融合术的患者。 30例患者均接受打顶治疗（第1组），其中69例接受了标准程序（第2组）。第一组的18例患者（60％）和第二组的38例患者（55％）发生了自闭症。差异不显着（P> 0.05）。在17例患者中（17％），仪器在LL顶点停止。 14/17例患者（82％）患有自闭症。这种影响是显着的（P <0.05）。腰椎的器械融合不应止于腰曲线的顶点。混合动态注视不会降低ASD的发生率。
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