title: Management of adjacent segment disease after cervical spinal fusion.
abstract: Adjacent segment disease (ASD) was described after long-term follow-up of patients treated with cervical fusion. The term describes new-onset radiculopathy or myelopathy referable to a motion segment adjacent to previous arthrodesis and often attributed to alterations in the biomechanical environment after fusion. Evidence suggests that ASD affects between 2% and 3% of patients per year. Although prevention of ASD was one major impetus behind the development of motion-sparing surgery, the literature does not yet clearly distinguish a difference in the rate of ASD between fusion and disk replacement. Surgical techniques during index surgery may reduce the rate of ASD.
authors.affiliation: Department of Orthopaedic Surgery, Thomas Jefferson University & Rothman Institute, 1015 Walnut Street, Room 801, Philadelphia, PA 19107, USA. chris.kepler@gmail.com
authors.forename: Christopher K
authors.initials: CK
authors.lastname: Kepler
authors.forename: Alan S
authors.initials: AS
authors.lastname: Hilibrand
mesh_terms: D000368:Aged; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D019299:Decompression, Surgical / Q000009:adverse effects* / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007403:Intervertebral Disc / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D011183:Postoperative Complications / Q000175:diagnosis / Q000601:surgery; D011300:Preoperative Care; D011843:Radiculopathy / Q000209:etiology / Q000601:surgery; D011859:Radiography; D012008:Recurrence; D012086:Reoperation / Q000379:methods; D018570:Risk Assessment; D013118:Spinal Cord Diseases / Q000209:etiology / Q000601:surgery; D013123:Spinal Fusion / Q000009:adverse effects* / Q000379:methods; D055009:Spondylosis / Q000175:diagnosis / Q000601:surgery*; D013997:Time Factors; D059145:Total Disc Replacement / Q000379:methods*; D016896:Treatment Outcome