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Spine
intermediate
X-Type

Adjacent Segment Disease - Risk Factors and Prevention Strategies

Degenerative Spine

A 58-year-old woman presents with new-onset radiculopathy 7 years after L4-5 posterior lumbar interbody fusion. She had excellent relief of her original L5 radiculopathy after the index surgery. Now she reports left L4 radiculopathy with weakness in knee extension. MRI shows L3-4 disc herniation with neural foraminal stenosis, moderate facet hypertrophy, and early disc degeneration at L3-4. The L4-5 fusion is solid. The surgeon discusses the concept of adjacent segment disease and factors that may have contributed. Regarding adjacent segment disease (ASD) following spinal fusion:

Mark each as TRUE or FALSE

A

Adjacent segment DISEASE (ASD) refers to SYMPTOMATIC degeneration at levels adjacent to a spinal fus...

B

Risk factors for ASD include longer fusion constructs (more levels fused), fusion ending at JUNCTION...

C

Cervical disc arthroplasty has been DEFINITIVELY proven to completely prevent adjacent segment disea...

D

The mechanism of ASD involves increased stress and hypermobility at levels adjacent to a rigid fusio...

E

Prevention strategies include restoring and maintaining sagittal balance (PI-LL mismatch within 10°)...

Answer the questions to see explanations

Click T (True) or F (False) for each option