Surgical risk factors associated with the development of adjacent segment pathology in the lumbar spine

November 12, 2021

Review

. 2021 Oct 19;6(10):966-972.

doi: 10.1302/2058-5241.6.210050.

eCollection 2021 Oct.

Affiliations

Item in Clipboard

Review

Eduardo Moreira Pinto et al.

EFORT Open Rev.

2021.

Abstract

Adjacent segment pathology (ASP) is a major cause of disability, and the recognition of the surgical risk factors associated with the development of this condition is essential for its prevention.Different surgical approaches, from decompression without fusion to non-instrumented and instrumented fusion, have distinct contributions to the development of ASP.Although motion-preservation procedures could reduce the prevalence of ASP, these are also associated with a higher percentage of complications.Several risk factors associated with previous surgery, namely the chosen surgical approach and anatomical dissection, the choice of interbody fusion, the increment and length of the fusion, and the restoration of sagittal alignment, may influence the development of ASP. Cite this article: EFORT Open Rev 2021;6:966-972. DOI: 10.1302/2058-5241.6.210050.

Keywords:

adjacent segment degeneration; adjacent segment disease; adjacent segment pathology; lumbar fusion; lumbar spine.

Conflict of interest statement

ICMJE Conflict of interest statement: The authors declare no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

**Fig. 1**

(a) Case example of an adjacent segment disease (ASD) after L2-S1 fusion. (b) First revision was made with a pedicle subtraction osteotomy at L3-L4, TLIF L1-L2 and T10 to ilium posterior fusion extension. (c and d) After one year of follow-up the patient developed an ASD at the cephalic level. The second revision was made with a T2 to ilium posterior fusion extension.

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