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Adjacent segment degeneration after fusion spinal surgery-a systematic review
Ko Hashimoto1,2, Toshimi Aizawa3, Haruo Kanno3
1Department of Orthopaedic Surgery, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan. hasshie@gmail.com.
International Orthopaedics
|November 25, 2018
Summary
Adjacent segment degeneration (ASDeg) and disease (ASDis) are common after fusion surgery. Risk factors vary by spinal region, and motion-preserving techniques may reduce incidence.
Area of Science:
- Spine surgery outcomes
- Degenerative spine disease
Background:
- Adjacent segment degeneration (ASDeg) and disease (ASDis) are significant complications following spinal fusion.
- Current understanding of ASDeg and ASDis incidence and risk factors remains incomplete.
Purpose of the Study:
- To systematically review the literature on the incidence, risk factors, and prevention of ASDeg and ASDis.
- To provide evidence-based information on ASDeg and ASDis following spinal fusion.
Main Methods:
- Systematic review of meta-analyses, randomized controlled trials, and cohort studies.
- Inclusion of studies published in English.
Main Results:
- Pooled incidence of ASDeg: 26.6% (lumbar) and 32.8% (cervical).
- 1/4 to 1/3 of ASDeg cases progress to ASDis.
- Identified numerous risk factors for ASDeg/ASDis, varying between cervical and lumbar spine.
- Motion-preserving surgeries show lower ASDeg/ASDis risk compared to fusion.
Conclusions:
- The literature highlights various factors contributing to ASDeg and ASDis.
- Further high-evidence studies are needed to guide prevention strategies for ASDeg and ASDis.
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