Adjacent Segment Disease is a condition caused by spinal fusions where the level above or below the fused vertebrae degenerate (because they are make up for the lack of movement at the level that was fused). The human spine is built for movement, when one of more levels are fused together it disturbs its normal movement. #Spinalfusion surgeries use bone grafts and/or hardware to permanently “lock” together two or more #vertebrae. The idea is to make the section of the spine thought to be causing pain immovable. After a #fusionsurgery, the spine loses the ability to move at the place where the procedure was done. Limiting the ability to bend forward, arch back, twist or tilt at the specific level or levels fused. “Locking” of the spine’s segment can force adjacent segments to compensate and try to keep the spine flexible. Unfortunately, this stresses and overloads those upper and lower vertebrae, forcing the intervertebral discs to break down and causing nerve compression and pain after back fusion leading to a condition known as #AdjacentSegmentDisease (ASD). ASD is most likely to occur in the motion segments of the spine used most often, such as L4/L5 and L5/S1 near the highly mobile lower lumbar region. They also tend to occur at the C5/C6 and C6/C7 near the highly mobile upper cervical region.
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Overloading of the adjacent #spinalvertebrae can result in a number of conditions in the adjacent segments, including:
- Bone spurs
- Spondylolisthesis
- Herniated discs
- Degenerative arthritis (facet joints)
- Stenosis (narrowing of the spaces for the nerves)
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These conditions can pinch the nerves in the spine, causing Radiculopathy (pain that radiates into the arms or legs) and Myelopathy (pain that travels along the spinal cord). Up to 25% of patients who have had fusions develop Adjacent Segment Disease about 5 years post-surgery (with higher risk in patients with 3- or 4- level fusions #discreplacement #spinalfusion #backsurgery #backpainrelief
