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• W3201324610 abstract "Adjacent segment disease (ASD) refers to symptomatic degeneration of a mobile segment cephalad or caudal to a fused segment, whereas adjacent segment degeneration (ASDeg) refers to radiographic evidence of pathology without accompanying symptoms. Symptoms of ASD include neurogenic claudication, radiculopathy, mechanical back pain, and progressive deformity. The risk of ASD after a lumbar fusion has been estimated to be 2% to 3% per year, although rates vary widely in the literature because of historically heterogeneous definitions. The etiology and pathogenesis of ASD are multifactorial and incompletely elucidated, but altered biomechanics of the spine following arthrodesis appear to play a major role. Such alterations and derangements include increased adjacent segment mobility, increased facet loading, and increased intradiscal pressure. Risk factors for ASD have been inconsistently demonstrated across studies but may include age, length of fusion, decompression adjacent to a fusion, termination of a fusion at the apex of a deformity, and preexisting degenerative changes at the adjacent segment. No techniques or devices placed at the time of the index operation, such as interspinous spacers or dynamic stabilization, have been definitively shown to reduce the risk of ASD. In the absence of an acute or progressive neurological deficit, nonoperative management of ASD is typically warranted. Operative intervention traditionally entails a posterior decompression, correction of deformity if present, and extension of instrumentation with fusion." @default.
• W3201324610 created "2021-09-27" @default.
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• W3201324610 date "2022-01-01" @default.
• W3201324610 modified "2023-09-23" @default.
• W3201324610 title "Adjacent Segment Disease After Fusion" @default.
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• W3201324610 doi "https://doi.org/10.1016/b978-0-323-71201-9.00022-6" @default.
• W3201324610 hasPublicationYear "2022" @default.
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