Adjacent Segment Disease: Understanding the Risks of Spinal Fusion

Accelerated adjacent segment degeneration, or adjacent segment disease, attributes the fusing of one or two levels in the spine to increased stress at the remaining adjacent levels of the spine. The adjacent levels then tend to degenerate at an accelerated rate because of the increased load and stress.

For cervical discogenic conditions such as herniated discs and bulging or ruptured discs, the accepted treatment for years has been the anterior cervical discectomy and fusion surgery, or ACDF. Although effective as a short-term positive outcome, the surgery has become very closely tied to an adverse long-term condition, adjacent segment disease. 

Studies have followed patients who have undergone anterior cervical discectomy and fusion surgeries and found that a significantly high percentage of patients demonstrate degeneration in the levels adjacent (beneath and above) the fused vertebrae. These patients usually require additional cervical fusion surgeries, a domino effect on the spine.

The cause of the increased risk for adjacent degeneration has been linked to the biomechanical stress of the fusion on the surrounding vertebrae after the fused vertebrae are deemed motionless. As many as one in five patients who have undergone a cervical fusion will require additional fusion surgeries on degenerated discs adjacent to their fusion.

The preservation of motion for the affected level in the initial treatment plan will prevent this increased stress to the spine and prevent accelerated degeneration in the levels surrounding the herniation or disc of concern. The best treatment option available that provides this preservation of motion for the disc is Deuk Laser Disc Repair as an alternative to cervical fusion surgery.

Deuk Laser Disc Repair uses an endoscope and a laser to remove the herniated disc material from the vertebral column and the pathways housing the delicate nerves and spinal cord. The disc is then able to heal itself and perform naturally as a buffer and shock absorber retaining a normal range of motion for the patient and reducing the risk of adjacent degeneration of the spine.

Deuk Spine Institute offers one of the safest and most effective neural foraminal stenosis treatments in the world. With a 95% success rate, fast recovery and it is easy to understand why people come from around the US to have cervical and lumbar foraminal stenosis surgery here. Get a free MRI review.

Adjacent segment illness isn’t caused solely by spinal fusion. Age-related degenerative changes in the spine may also cause the disorder.

Neighboring spinal discs and joints of a fusion site may have a history of degenerative alterations in some circumstances. The longer a patient is alive, the more likely the spine is to have progressed in its degenerative phase, increasing the risk of degenerative spinal illnesses related to ASD.

The medically identified risk factors of Adjacent Segment Disease are highlighted below:

• Toxic habits like smoking
• Old age
• Being biologically female
• Having invasive spinal fusion surgery in two or more spinal segments
• Having a previous degenerative spinal disorder e.g., herniated disc, collapsed disc

Adjacent Segment Disease is most common in the spinal segments with the most mobility and range of motion, such as L4-L5 and L5-S1, located in the highly mobile lumbar spine. Adjacent Segment Disease also affects the lower three segments of the subaxial spine, from the C4 to C7 vertebrae.

Adjacent Spinal Disease can cause various degenerative illnesses in the adjacent spinal segments, including herniated discs, spinal stenosis, spondylosis, spinal osteoarthritis, and scoliosis.

These disorders have the potential to compress nerves in the spine, resulting in discomfort and syndromes such as radicular pain that radiates into the arms or legs and spinal myelopathy. More causes of pain in the back and legs are explored in the video below;

The specific symptoms that patients with Adjacent Spinal Disease experience will depend on the degenerative disorders related to ASD and their locations within the spine. Adjacent Segment Disease usually causes symptoms comparable to those that initially led to the need for spinal fusion surgery.

Plain radiographs of the spine are generally enough to diagnose Adjacent Segment Disease. A person may have adjacent segment disease and be completely unaware of it, known as asymptomatic adjacent segment disease. Magnetic resonance imaging is the most likely method of detecting this variation. An MRI scan, which gives precise images of anomalies in soft tissues such as spinal nerves and intervertebral discs, clearly displays the degenerative changes associated with Adjacent Segment Disease.

The preservation of motion for the affected spinal level in the initial treatment plan will prevent any increased stress to the spine that might lead to accelerated degeneration in the levels surrounding the herniation or disc of concern. The best treatment option available for this preservation of motion for the disc is Deuk Laser Disc Repair as an alternative to cervical fusion surgery.

Deuk Laser Disc Repair

This revolutionary procedure is Deuk Spine Institute’s specialized alternative to dangerous invasive surgeries like spinal fusion or total disc replacement. The laser disc repair does not weaken or compromise the health and integrity of the spine. Our modernized approach to laser spine surgery has a 95% success rate with no complications in any patient over 15 years of performing this procedure and over 1,300 patients treated.

Process

Deuk laser disc repair surgery is a form of endoscopic spine surgery performed in our state of the art surgery center under sedation while the patient relaxes. This procedure is performed endoscopically with a small 7mm incision. The surgery is virtually bloodless and takes 30 minutes per disc being repaired. You heard correctly, your own natural disc will be repaired so that it no longer causes you pain and the effect is permanent.

Through a ¼ inch incision, the injured disc is visualized using an endoscope and live imaging via a high definition camera attached to the spinal endoscope.

With this method, Dr. Deukmedjian carefully eliminates only the injured disc tissue causing pain and discomfort and leaves the rest of the patient’s own natural disc in place to preserve spinal motion and function. Fusions and artificial discs are not necessary because the patient’s repaired natural disc is left in place. Watch Deuk Laser Disc Repair in action.

Deuk Laser Disc Repair uses a precision laser to vaporize the herniated tissue and provide the most effective laser spine surgery available. Bone and surrounding tissues are not damaged or removed during this procedure, unlike traditional microdiscectomy, artificial discs  and spinal fusions. 

Dr. Ara Deukmedjian uses FDA approved tools to access the disc through a natural space in the spine where he does not drill through bone as is done with microdiscectomy. Drilling through bone weakens the spine, which leads to future complications that may require fusion surgery.

Once the herniation and annular tear have been gently vaporized, the body can heal naturally. Irritation around the spine decreases, and neurological symptoms from nerve root pressure subside. In time, the disc functions as it did before injury and herniation.

After surgery, patients wake up to immediate relief and a surgical scar so small the surgeon can cover it with a Band-aid. Only a few drops of blood are lost and no hospitalization is required.

All 1,300 Deuk Laser Disc Repair surgeries done to date have been outpatient with a 1 hour recovery.

Why would anyone want invasive, dangerous surgery that works less than 50% of the time? In fact, when you really understand how Deuk Laser Disc Repair compares to traditional surgeries like microdiscectomy, laminectomy, spinal fusion or total disc replacement, your mind is easily made. Traditional spine surgery is dangerous to your health and a risk that is unnecessary to take.  

A patient with a 2-year-old anterior cervical discectomy and fusion at the c5-c6 level presents with pain in the neck, or cervical spine, increased with movement. MRI findings indicate clinically significant disc disease in the levels adjacent to the cervical fusion at C4-C5 and C6-C7. The patient is recommended for two additional cervical fusion surgeries on the adjacent levels showing a diseased state resulting in loss of motion in three spine levels, and the risk for even greater accelerated degeneration on the remaining spinal discs.

Are you or a loved one experiencing back pain or other symptoms? Deuk Spine Institute is always accepting new patient inquiries. To learn more, contact us or give us a call at 1-800-FIX-MY-BACK.