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Orthop Clin North Am. 2012 Jan;43(1):53-62, viii. doi: 10.1016/j.ocl.2011.08.003. Epub 2011 Oct 13.

Management of adjacent segment disease after cervical spinal fusion.

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Department of Orthopaedic Surgery, Thomas Jefferson University & Rothman Institute, 1015 Walnut Street, Room 801, Philadelphia, PA 19107, USA.


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.

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