Adjacent Segment Disease: A Complication? 

For starters, "funding generously provided by Synthes" kind of tells you a lot from the get-go. So I think slamming the SAS group for being biased is quite disingenuous. Anyway, once upon a time (i.e., about a decade ago), diehard advocates of open fusion techniques argued that obliterating the spine's motion wouldn't cause adjacent segment disease - because "natural history" of course - albeit, fusion might speed up this "natural history" (see 10:20) 😂... They also argued that MIS (tubular) technique wasn't really all that great as far as surgical complication, cost-effectiveness, patient satisfaction, etc... were concerned. Funny how MIS vindicated itself and became the working standard anyways. (And now, the shoe is on the other foot -- with some MIS advocates now saying what was said of them a decade ago to describe the latest endoscopic spine surgery techniques.) 😊 Times change, technologies change, but human nature stays the same.

Had an open TLIF on L4-5 and L5-S1 years ago that was technically successful but I developed epidural fibrosis of the nerve roots. I also have multi level spinal arthritis, facet hypertrophy, DDD, and stenosis. Im guessing I am genetically susceptible to rapid degenerative changes in my spine. Also suffering from OA and RA. This was very informative and i wish i had been more aware of surgical complications back then.

I dont believe its genetic. I never had any neck or back problems until a herniated c7-t1 that I had fusion on in 2006. Thirteen years later the t1-t2 is now gone and requires surgery. If not for that first fussion that second injury would never have happened. My spine is not degenerating anywhere else. I had a fusion, now I have ASD.

As a failed spinal fusion patient, don't undergo a knife! These surgeons don't offer us no cure.

Adjacent Segment Disease (ASD) is a BIG deal. 6 to 12 years after a fusion, then the next level is burned out. I see fusions as necessary in only cases where the patient is not a good candidate for artificial implants. I traveled to Barcelona Spine Center in 2016 and had the Spinal Kinetics M6L lumbar implant and paid $26k and returned in 2018 for a double level cervical ESP discs and paid $35k. VERY happy. The main difference is a cushion effect. The US implants are hard so may not work as well.

ASD is a complication. Europe is not seeing ASD returns after 14 years with the Spinal Kinetics M6. Because it restores motion and has a cushion effect design, the energy transfer is dampened. Many disc implants are hard, a big problem.