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Answer to the Letter to the Editor of J. Deng, et al. concerning "Spontaneous facet fusion following lateral lumbar interbody fusion supplemented with percutaneous pedicle screw fixation in degenerative lumbar disease" by Soh J, et al. (Eur Spine J [2025]; doi: 10.1007/s00586-025-09227-8).

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Adjacent Segment Pathology after Lumbar Spinal Fusion.

Jae Chul Lee1, Sung-Woo Choi1

  • 1Department of Orthopaedic Surgery, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea.

Asian Spine Journal
|October 6, 2015
PubMed
Summary

Adjacent segment pathology (ASP) is a clinical issue after lumbar spinal fusion due to increased stress. Understanding risk factors and considering motion-preserving devices can help prevent ASP and guide surgical decisions.

Keywords:
Adjacent segment diseaseAdjacent segment pathologyLumbar spineSpinal fusion

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Area of Science:

  • Spine surgery
  • Orthopedics
  • Biomedical engineering

Background:

  • Adjacent segment pathology (ASP) is a common complication following lumbar spinal fusion.
  • It arises from increased mechanical stress on spinal segments adjacent to the fused area.
  • ASP can lead to radiographic changes and clinical symptoms, potentially requiring further surgery.

Purpose of the Study:

  • To review the clinical issues, risk factors, and management strategies for adjacent segment pathology after lumbar spinal fusion.
  • To discuss the role of motion-preserving devices in preventing ASP.

Main Methods:

  • Literature review of studies on adjacent segment pathology after lumbar spinal fusion.
  • Analysis of reported incidence, risk factors, and outcomes.
  • Evaluation of evidence for motion-preserving devices.

Main Results:

  • The incidence of ASP varies significantly based on study definitions and methodologies.
  • Several risk factors have been identified, but their significance remains debated.
  • Motion-preserving devices show potential efficacy in preventing ASP.

Conclusions:

  • Surgeons must be aware of ASP risk factors when planning lumbar spinal fusion.
  • Preoperative patient counseling regarding ASP risks is crucial.
  • Further research is needed to clarify risk factor significance and optimize prevention strategies.