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Updated: Feb 6, 2026

Transforaminal Full-Endoscopic Lumbar Foraminotomy Under Local Anesthesia for L5/S1 Adjacent Segment Foraminal Stenosis
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Surgery for postarthrodesis adjacent-cervical segment degeneration.

Hooman Azmi1, Richard P Schlenk

  • 1Neurological Institute of New Jersey, University of Medicine and Dentistry of New Jersey, New Jersey Medical School, Newark, New Jersey 07103, USA. hooman az@hotmail.com

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Summary

Anterior cervical fusion can lead to adjacent-segment disease, a common complication causing pain and worsening symptoms in some patients. This review examines the causes, prevention, and treatment of this condition following spinal fusion surgery.

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Area of Science:

  • Orthopedics
  • Neurosurgery
  • Spine Surgery

Background:

  • Anterior cervical decompression and fusion (ACDF) is a common procedure for various cervical spine disorders.
  • Long-term studies indicate that degenerative changes can occur in spinal segments adjacent to the fused area.
  • Adjacent-segment disease (ASD) is a significant complication, affecting up to 25% of patients post-ACDF for cervical spondylotic myelopathy.

Purpose of the Study:

  • To review the current literature on the pathogenesis, prevention, and treatment of postarthrodesis adjacent-segment degenerative disease.
  • To synthesize existing knowledge regarding the development and management of ASD after cervical fusion.

Main Methods:

  • Comprehensive literature search of studies on ACDF and ASD.
  • Review and synthesis of findings related to ASD etiology, prophylaxis, and therapeutic strategies.

Main Results:

  • The causes of ASD are still debated, highlighting the complexity of the condition.
  • Degenerative changes at adjacent segments are a recognized long-term consequence of cervical fusion.
  • Symptomatic deterioration due to ASD can occur in a substantial percentage of patients.

Conclusions:

  • ASD is a critical consideration in the long-term management of patients undergoing ACDF.
  • Further research is needed to fully elucidate the pathogenesis and optimize prevention and treatment strategies for ASD.