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CONDITIONS

Adjacent Segment Disease

Adjacent segment disease (ASD) is a condition that may occur after spinal fusion surgery. A spinal fusion involves joining two or more vertebrae together, often done to address spinal instability, reduce pain, and address other symptoms associated with spinal disorders. The fusion alters the biomechanics of the spine, potentially causing additional stress on nearby segments over time. If you’re affected by ASD, the spinal segments adjacent to the fused area experience this increased stress or undergo degeneration, leading to various issues.

Symptoms & Diagnosis

The symptoms of adjacent segment disease can vary widely among individuals and may range in severity. The manifestation and progression of symptoms depend on several factors, including the patient’s overall health, the specific spinal segments involved, and the individual variations in anatomy. Symptoms may include:

  • Pain Patients may experience localized pain in the segments adjacent to the fused area. This pain can be dull, aching, or sharp and may worsen with certain movements or activities.
  • Stiffness Stiffness in the spine, particularly in the adjacent segments, is a common symptom of ASD. This can contribute to reduced flexibility and mobility.
  • Decreased range of motion Patients may notice a limitation in their ability to move the spine, especially in the segments neighboring the fusion site.
  • Numbness or tingling Nerve compression due to degeneration or changes in adjacent segments may lead to sensations of numbness, tingling, or weakness in the arms or legs.
  • Radiating pain Pain may radiate from the adjacent segments into surrounding areas, affecting nearby nerves and tissues.
  • Stenosis or disc herniation In some cases, ASD can contribute to the development of new disc herniations or bone spurs in the segments next to the fused area, causing additional symptoms from nerve pinching.

ASD is most often diagnosed through an MRI, after a physical examination and review of medical history. An MRI will clearly show any changes in the spine associated with the condition, as it can produce detailed images of abnormalities in the nerves, discs, and other structures.

Treatment

The treatment of ASD depends on the severity of symptoms and may involve both conservative and surgical interventions. The goal is to alleviate pain, improve function, and address any spinal instability or degeneration in the adjacent segments. If surgical intervention is needed, Dr. Avramis uses advanced surgical techniques to reduce tissue disruption, minimize recovery time, and alleviate symptoms.

Conservative management
  • Physical therapy Exercises and stretches can help improve flexibility, strengthen supporting muscles, and reduce pain.
  • Medication Nonsteroidal anti-inflammatory drugs (NSAIDs) and muscle relaxers may be prescribed to manage pain and inflammation.
  • Activity modification Adjustments to daily activities or work ergonomics may be recommended to minimize stress on the spine.
Pain management
  • Epidural steroid injections Injections of corticosteroids into the affected area may provide temporary relief from pain and inflammation.
  • Facet joint injections Injection of medications into the facet joints can help alleviate pain associated with ASD.
Bracing
  • In some cases, bracing may be considered to provide additional support and stability to the spine.
Surgical intervention
  • Revision surgery In cases where symptoms are severe and conservative measures are ineffective, revision surgery may be considered to address the degeneration or instability in the adjacent segments.
  • Extension of fusion Extending the existing fusion to include the adjacent segments may be performed to stabilize the spine further.
It’s important to note that not everyone who undergoes spinal fusion will develop ASD. However, managing ASD is key to ensuring the long-term success of spinal surgeries. Patients undergoing spinal fusion should have regular follow-ups with their healthcare provider to detect and manage any potential complications, including adjacent segment disease.
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Our team at Avramis Spine & Scoliosis is here to help. To request an appointment or for any other inquiries, please fill out the form.

GET IN TOUCH

Contact

Our team at Avramis Spine & Scoliosis is here to help. To request an appointment or for any other inquiries, please fill out the form.