This 2013 narrative review examines adjacent segment disease (ASD) following cervical spine surgery, synthesizing data on incidence after ACDF, the effect of nonfusion alternatives (anterior diskectomy alone, posterior foraminotomy), and whether artificial disk replacement reduces ASD rates compared with fusion.
When counseling patients before cervical fusion, quote roughly 1-in-4 developing symptomatic ASD within a decade—but emphasize that motion-preserving alternatives including posterior foraminotomy and artificial disk replacement have not proven superior to ACDF for preventing this complication.
Intraoperatively, use anatomic landmarks rather than blind needle-stick disk localization and keep your anterior plate at least 5 mm from adjacent disk spaces to minimize modifiable degeneration risk.
This 2013 narrative review examines adjacent segment disease (ASD) following cervical spine surgery, synthesizing data on incidence after ACDF, the effect of nonfusion alternatives (anterior diskectomy alone, posterior foraminotomy), and whether artificial disk replacement reduces ASD rates compared with fusion.
When counseling patients before cervical fusion, quote roughly 1-in-4 developing symptomatic ASD within a decade—but emphasize that motion-preserving alternatives including posterior foraminotomy and artificial disk replacement have not proven superior to ACDF for preventing this complication.
Intraoperatively, use anatomic landmarks rather than blind needle-stick disk localization and keep your anterior plate at least 5 mm from adjacent disk spaces to minimize modifiable degeneration risk.