Overview
After a spinal fusion, the levels above and below the fused segment take on more motion and load. Over time, some people develop disc degeneration, stenosis or instability at an adjacent level. When this causes symptoms, it is called adjacent segment disease.
Not everyone with changes on imaging needs treatment. Care is based on symptoms, exam and how the imaging matches.
Watch and learn
Video: “Adjacent Segment Disease - Patient Animation” from Globus Medical on YouTube. It loads from youtube-nocookie.com only when you press play. Shown for general education; GSMC did not produce it. Watch on YouTube
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Symptoms
- New or returning back or neck pain after a period of relief
- Leg or arm pain, numbness or weakness
- Pain with walking that eases with sitting (stenosis)
Causes
- Increased stress on levels next to a fusion
- Natural age-related degeneration
- Length and position of the prior fusion
How it is diagnosed
X-rays (including bending views) check the fusion and alignment; MRI or CT myelogram shows stenosis or disc problems at adjacent levels.
Treatment options, step by step
A spine surgeon looks at the whole picture, including options short of surgery. Not every step applies to every person.
Self-care and lifestyle
Activity, walking, core strength and weight management.
Physical therapy and medications
Physical therapy and medicines.
Injections and nerve blocks
Epidural injections, facet injections or nerve blocks.
Minimally invasive procedures
Spinal cord stimulation or other minimally invasive options for selected patients.
Surgical evaluation
Revision surgery to decompress and extend a fusion may be considered.
Nonsurgical alternatives
Many spine problems are managed without surgery. See our nonsurgical options and holistic and lifestyle care guides.
Related surgeries
Call 732-202-3000 to confirm which surgeon performs this procedure and where.
When to seek urgent care
Call 911 or go to the emergency department for new or rapidly worsening weakness, numbness in the groin or inner thighs, loss of bladder or bowel control, or severe pain after a fall or accident.
Frequently asked questions
Will I get adjacent segment disease after a fusion?
Many people do not. It is one of the known long-term considerations of fusion, and your surgeon can discuss your individual risk.
Can it be treated without surgery?
Often yes. Therapy, medicines and injections are usually tried first.
Can disc replacement prevent it?
Motion-preserving surgery is designed partly with this in mind; whether it is an option depends on your condition.
This page is general patient education and does not replace advice from your own clinician. Individual results vary.