Management of adjacent segment disease after cervical spinal fusion

Orthop Clin North Am. 2012 Jan;43(1):53-62, viii. doi: 10.1016/j.ocl.2011.08.003. Epub 2011 Oct 13.

Abstract

Adjacent segment disease (ASD) was described after long-term follow-up of patients treated with cervical fusion. The term describes new-onset radiculopathy or myelopathy referable to a motion segment adjacent to previous arthrodesis and often attributed to alterations in the biomechanical environment after fusion. Evidence suggests that ASD affects between 2% and 3% of patients per year. Although prevention of ASD was one major impetus behind the development of motion-sparing surgery, the literature does not yet clearly distinguish a difference in the rate of ASD between fusion and disk replacement. Surgical techniques during index surgery may reduce the rate of ASD.

Publication types

  • Review

MeSH terms

  • Aged
  • Cervical Vertebrae / diagnostic imaging
  • Cervical Vertebrae / pathology
  • Cervical Vertebrae / surgery*
  • Decompression, Surgical / adverse effects*
  • Decompression, Surgical / methods
  • Female
  • Follow-Up Studies
  • Humans
  • Intervertebral Disc / surgery*
  • Male
  • Middle Aged
  • Patient Selection
  • Postoperative Complications / diagnosis
  • Postoperative Complications / surgery
  • Preoperative Care
  • Radiculopathy / etiology
  • Radiculopathy / surgery
  • Radiography
  • Recurrence
  • Reoperation / methods
  • Risk Assessment
  • Spinal Cord Diseases / etiology
  • Spinal Cord Diseases / surgery
  • Spinal Fusion / adverse effects*
  • Spinal Fusion / methods
  • Spondylosis / diagnosis
  • Spondylosis / surgery*
  • Time Factors
  • Total Disc Replacement / methods*
  • Treatment Outcome