title: Management of degenerative disc disease above an L5-S1 segment requiring arthrodesis.
abstract: Clear guidelines exist for treating spondylolisthetic deformity and instability. How the surgeon handles adjacent-level degenerative disease is not as well established. Because magnetic resonance imaging now provides us with far more information on the "health" of radiographically normal intervertebral discs, the treatment of dehydrated or degenerated discs adjacent to a fusion is becoming more problematic. In this discussion, two experts discuss their approach to symptomatic lumbosacral spondolisthesis accompanied by adjacent-level disc degeneration. Drs. Herkowitz and Abraham believe strongly that the adjacent segment should be left alone, whereas Dr. Albert recommends extending the fusion in many instances.
authors.affiliation: Department of Orthopaedic Surgery, William Beaumont Hospital, Royal Oak, Michigan, USA.
authors.forename: H N
authors.initials: HN
authors.lastname: Herkowitz
authors.forename: D J
authors.initials: DJ
authors.lastname: Abraham
authors.forename: T J
authors.initials: TJ
authors.lastname: Albert
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000473:pathology / Q000601:surgery*; D008159:Lumbar Vertebrae / Q000473:pathology / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D012447:Sacrum / Q000473:pathology / Q000601:surgery*; D013123:Spinal Fusion; D013168:Spondylolisthesis / Q000175:diagnosis / Q000601:surgery*