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Adjacent Segment Disease After Lumbar Spinal Fusion: A Systematic Review of the Current Literature

Authors
Journal
Seminars in Spine Surgery
1040-7383
Publisher
Elsevier - WB Saunders
Publication Date
Volume
23
Issue
4
Identifiers
DOI: 10.1053/j.semss.2011.05.008
Keywords
  • Adjacent Level Degeneration
  • Adjacent Segment Degeneration
  • Adjacent Segment Disease
  • Lumbar Fusion
  • Spine
Disciplines
  • Medicine
  • Physics

Abstract

The objectives are to comprehensively define adjacent segment disease; highlight advances in the approach to spinal disorders, present the identified risk factors; examine outcomes; and summarize current recommendations. The literature supports previous degeneration and altered biomechanics of the spine as causes of adjacent segment disease. Excessive facet degeneration is a risk factor. Clinical outcome scores show improvement irrespective of procedure type. The number of spinal segments fused, fusion level, and age yield conflicting reports regarding their contribution to adjacent segment disease. Arthroplasty, dynamic stabilization, and interspinous process implants are effective in decreasing incidence.

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