• Users Online: 251
  • Print this page
  • Email this page
Year : 2023  |  Volume : 6  |  Issue : 1  |  Page : 3-14

Adjacent segment disease: Current evidence and the role of motion preservation technologies

Department of Spine Services, Indian Spinal Injuries Center, New Delhi, Delhi, India

Correspondence Address:
Harvinder Singh Chhabra
Department of Spine Services, Indian Spinal Injuries Center, D6, Infront of Vasant Valley School, Vasant Kunj, New Delhi 110070, Delhi
Login to access the Email id

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/isj.isj_61_22

Rights and Permissions

Spinal fusion is gold-standard treatment for degenerative disc disease (DDD) both at cervical and lumbar spine, and it is time tested. Perhaps it has its bundle of complications. Elimination of motion results in accentuated degeneration of adjacent segments leading to adjacent segment degeneration radiographically and, if symptomatic, leads to adjacent segment disease. There is still a debate on whether there is such an entity or whether it is a manifestation of natural history or an iatrogenic phenomenon. Motion preservation surgeries were developed to address the same issue, which includes total disc replacement, nucleus replacement, interspinous implants, and dynamic posterior stabilization systems. The primary goal of motion preservation surgery is to maintain normal or near-normal motion in an attempt to prevent adverse outcomes, which are commonly seen with conventional spinal fusion, most notably the development of adjacent-level DDD. A search was conducted in PubMed using the terms (“adjacent segment”) AND (“disease” OR “degeneration” or “pathology”). Then the articles were shortlisted based on time of publication (2005 onward), publication in English and inclusion of human subjects. This resulted in 253 articles. Another search for ((“Motion preservation”) AND (“Spine”)) OR (“Adjacent segment disease”) OR (“Adjacent segment pathology”) OR (“Adjacent segment degeneration”) yielded 76 articles. This narrative review discusses various issues pertaining to the current evidence regarding adjacent segment disease (ASD), including the controversy on whether ASD is actually an entity, its etiopathogenesis, clinical features, as well as the role of motion preservation technologies to reduce its incidence. There is still enthusiasm and concerns regarding the benefits of motion preservation surgery since it is still an area of ongoing research.

Print this article     Email this article
 Next article
 Previous article
 Table of Contents

 Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
 Citation Manager
 Access Statistics
 Reader Comments
 Email Alert *
 Add to My List *
 * Requires registration (Free)

 Article Access Statistics
    PDF Downloaded90    
    Comments [Add]    

Recommend this journal