Update on the evidence for adjacent segment degeneration and disease.

Publication/Presentation Date

3-1-2013

Abstract

BACKGROUND CONTEXT: The evidence surrounding the topic of adjacent segment degeneration and disease has increased dramatically with an abundant amount of literature discussing the incidence of and techniques to avoid it. However, this evidence is often confusing to discern because of various definitions of both adjacent segment degeneration and disease.

PURPOSE: To organize and review the recent evidence for adjacent segment degeneration and disease.

RESULTS: Although multifactorial, three distinct causes of adjacent segment disease in both the lumbar and cervical spine have been discussed: the natural history of the adjacent disc; biomechanical stress on the adjacent level caused by the fusion; and disruption of the anatomy at the adjacent level with the initial surgery. The incidence of adjacent segment degeneration in the lumbar spine has been widely reported in the literature from 0% to 100%; conversely, the reported incidence in the cervical spine is less variable. Similarly, strategies at avoiding adjacent segment disease in the lumbar spine include arthroplasty, dynamic fixation, and percutaneous fixation, whereas in the cervical spine the focus has remained on arthroplasty.

CONCLUSIONS: Adjacent segment disease and degeneration remain a multifactorial problem with several techniques being developed recently to minimize them. In the future, it is likely that the popularity of these techniques will be dependent on the long-term results, which are currently unavailable.

Volume

13

Issue

3

First Page

342

Last Page

351

ISSN

1878-1632

Disciplines

Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods

PubMedID

23420004

Department(s)

Administration and Leadership

Document Type

Article

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