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An Overview of Adjacent Segment Disease and Treatment

Adjacent Segment Disease

Adjacent Segment Disease is a condition that results from the development of complications after previous spine surgery, or from a natural degeneration of the spine over time. Research studies show that ASD is most common after lumber fusion surgery, occurring at a rate of three to fourteen percent. After a fusion procedure takes place, there is an increase in the load imposed on the vertebrae and discs above and below the surgical site. Of the surgical procedures now in use, the anterior cervical discectomy and fusion technique has shown a greater tendency to place an individual at a higher risk of developing ASD. People over the age of 55 and post-menopausal women are at the greatest danger of developing the condition.

The exact cause of ASD are unclear but appear to be related to the stress placed on the vertebrae next to the surgical site. The fused vertebrae are no longer able to move, creating more strain on the surrounding discs and vertebrae due to the constantly increased motion of those segments. 43% of those with cervical ASD also have spinal misalignments.

Symptoms of ASD include:

  • Scoliosis
  • Thoracic and Lumbar stenosis
  • Herniation of the disc core
  • Spinal arthritis
  • Facet Joint degeneration

A physician diagnoses ASD by review of x-ray, MRI, and CT scan imaging. Unfortunately, it can be quite difficult to determine if the further degeneration of discs and vertebrae next to the surgical site is due to ASD or simply an independent progressive degeneration.

There is no standard treatment for ASD. Surgical options are additional discectomy and fusion, depending on the location of the problem. However, new advances in disc repair are showing promise, and offer a potential alternative solution by helping to preserve motion and eliminate the need for further fusion at other levels.

If you have had previous spine surgery without resolution of pain or other symptoms and are interested in learning about additional treatment choices, please contact us at our New Braunfels or Seguin offices.

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