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

Eduardo Moreira Pinto; Artur Teixeira; Ricardo Frada; Pedro Atilano; António Miranda

doi:10.1302/2058-5241.6.210050

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

EFORT Open Rev. 2021 Oct 19;6(10):966-972. doi: 10.1302/2058-5241.6.210050. eCollection 2021 Oct.

Authors

Eduardo Moreira Pinto¹, Artur Teixeira¹, Ricardo Frada¹, Pedro Atilano¹, António Miranda¹

Affiliation

¹ Orthopaedic and Traumatology Surgery, Spine Division, Entre Douro e Vouga Hospital Center, Santa Maria da Feira, Portugal.

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.

Publication types

Review