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Adjacent Segment Disease in the Cervical and Lumbar Spine
- Source :
- Clinical spine surgery. 30(3)
- Publication Year :
- 2016
-
Abstract
- Adjacent segment disease (ASD) is disappointing long-term outcome for both the patient and clinician. In contrast to adjacent segment degeneration, which is a common radiographic finding, ASD is less common. The incidence of ASD in both the cervical and lumbar spine is between 2% and 4% per year, and ASD is a significant contributor to reoperation rates after spinal arthrodesis. The etiology of ASD is multifactorial, stemming from existing spondylosis at adjacent levels, predisposed risk to degenerative changes, and altered biomechanical forces near a previous fusion site. Numerous studies have sought to identify both patient and surgical risk factors for ASD, but a consistent, sole predictor has yet to be found. Spinal arthroplasty techniques seek to preserve physiological biomechanics, thereby minimizing the risk of ASD, and long-term clinical outcome studies will help quantify its efficacy. Treatment strategies for ASD are initially nonoperative, provided a progressive neurological deficit is not present. The spine surgeon is afforded many surgical strategies once operative treatment is elected. The goal of this manuscript is to consider the etiologies of ASD, review its manifestations, and offer an approach to treatment.
- Subjects :
- medicine.medical_specialty
genetic structures
Radiography
medicine.medical_treatment
Degeneration (medical)
behavioral disciplines and activities
Arthroplasty
03 medical and health sciences
0302 clinical medicine
mental disorders
medicine
Humans
Orthopedics and Sports Medicine
030222 orthopedics
Lumbar Vertebrae
business.industry
Incidence (epidemiology)
Spinal arthrodesis
Surgery
Spinal Fusion
Etiology
Cervical Vertebrae
Lumbar spine
Spinal Diseases
Neurology (clinical)
Adjacent segment disease
business
030217 neurology & neurosurgery
Subjects
Details
- ISSN :
- 23800194
- Volume :
- 30
- Issue :
- 3
- Database :
- OpenAIRE
- Journal :
- Clinical spine surgery
- Accession number :
- edsair.doi.dedup.....58813b93daa3cb838a04e2b2fb7b228f