Adjacent Segment Disease: Incidence

By | May 3, 2015

For some people a single level lumbar fusion may create a domino like effect that is impossible to stop.

For some people a single level lumbar fusion may create a domino like effect that is impossible to stop.

The real mystery is why some people get it and some people don’t. If increased wear and tear on the next segment above or below were an inexorable concomitant of all fusions we would expect to see it to some degree in all cases of fusion, worse in some and less severe in other patients. Furthermore we would expect that the incidence of adjacent segment disease to increase steadily with time. This however is not the case. It is clear from my experience at Schlesinger Pain Centers that some people get adjacent segment disease, most within the first five years, while others never will. It is true that the incidence of adjacent segment disease increases with the number of levels fused. Patients undergoing one level fusions have an incidence of adjacent segment disease of not more than 10%, while patients with 2 levels fused have in incidence of 20-25% and patients with three or more levels fused have an incidence of adjacent segment disease of 50% or more.


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