Risk factors and treatment strategies for adjacent segment disease following spinal fusion (Review)

作者：Xing Huang, Yong Cai, Kai Chen, Qiang Ren, Bo Huang, Gang Wan, Yuchen Wang, Jincheng Lin, Jun Zhao · 发表于：Molecular Medicine Reports · 年份：2024 · DOI：10.3892/mmr.2024.13398 · 被引用次数：28 · 研究领域：Spine and Intervertebral Disc Pathology、Cervical and Thoracic Myelopathy、Spinal Fractures and Fixation Techniques

Adjacent segment disease (ASD) is a significant clinical complication following cervical and lumbar spinal fusion surgery, characterized by the degeneration of spinal segments adjacent to the fused area. The present literature review aimed to elucidate the risk factors contributing to ASD and to evaluate current and emerging treatment strategies. Epidemiological data indicate that patient‑related factors such as age, pre‑existing spinal degeneration and comorbidities, along with surgical factors including the type of fusion, instrumentation and alignment correction, play pivotal roles in ASD development. Biomechanical alterations post‑fusion further exacerbate the risk. The underlying mechanisms of ASD involve changes in spinal kinematics and disc degeneration, driven by inflammatory and degenerative processes. Diagnostic modalities, such as magnetic resonance imaging and computed tomography scans, are essential for early detection and accurate diagnosis. Preventive strategies emphasize meticulous preoperative planning, advanced surgical techniques and postoperative rehabilitation. Treatment approaches range from conservative methods such as physical therapy and pharmacological interventions to surgical solutions, including revision surgeries and the use of motion‑preserving technologies. Emerging therapies, particularly in regenerative medicine, show promise in mitigating ASD. The present review underscored the necessity of a multidisciplinary approach to optimize patient ou...