Adjacent segment degeneration is a major buzzword in spine surgery.
Adjacent Segment Degeneration refers to the degeneration of an intervertebral
disc above or below vertebras previously fused together.
The intervertebral spinal discs act as shock absorbers. The concern is
that the disc above or below a fused level will have to absorb more shock,
and may have accelerated wear and tear because of the increased forces
placed on those discs. It appears that with longer fusions, there may be
a higher risk of Adjacent Segment Degeneration. It is very important that
the surgeon maintains the natural spinal balance and curvature of the cervical
spine while performing a fusion. Keeping the spine balanced will help to
decrease the wear and tear on adjacent levels and lower the chances of
spinal degeneration. Dr. Robert Pashman has long believed that balance is the key to a sucessful spine surgery.
There is a substantial amount of literature supporting the theory of Adjacent Segment Degeneration. Concern for motion preservation and adjacent segment degeneration led to the development of Artificial Disc Replacement technology. (See Prestige Cervical Disc). Artificial Disc Replacement preserves normal motion (yes/no motion) in the spine therefore eliminating the increase demands upon the adjacent levels. Although it remains to be seen, it appears in initial studies that this may decrease the risk of adjacent segment degeneration.
To review cases Dr. Pashman has performed, please see the Review of Cases.