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  • Journal of Neurosurgery: Spine x
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Chao-Hung Kuo, Wen-Cheng Huang, Jau-Ching Wu, Tsung-Hsi Tu, Li-Yu Fay, Ching-Lan Wu and Henrich Cheng

-grade spondylolisthesis. 3 , 11–13 However, few reports have addressed the true incidence of adjacent-segment degeneration (ASD) after these spinal surgeries. The pathological process observed at the spinal disc adjacent to the level that was treated with arthrodesis is regarded as ASD. Owing to advances in image technology, asymptomatic ASD can be identified by abnormal findings on radiological examinations; these findings include disc degeneration, segmental instability, or spinal stenosis and are termed “radiological ASD.” These radiological ASDs can be completely free of symptoms

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Justin K. Scheer, Justin S. Smith, Frank Schwab, Virginie Lafage, Christopher I. Shaffrey, Shay Bess, Alan H. Daniels, Robert A. Hart, Themistocles S. Protopsaltis, Gregory M. Mundis Jr., Daniel M. Sciubba, Tamir Ailon, Douglas C. Burton, Eric Klineberg, Christopher P. Ames and The International Spine Study Group

T he surgical management of adult spinal deformity (ASD) can provide significant improvements in pain, disability, and health-related quality of life (HRQOL). 6 , 7 , 28 , 34 , 36–38 , 40–45 However, these procedures are technically demanding and are associated with a high complication rate. The patient population suitable for these complicated surgeries continues to increase, including patients of advanced age. 2 , 16 , 17 , 27 The reported complication rates in the literature are varied and range from 14% to 71%. 11 , 13 , 39 , 47 , 48 It has been

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Takashi Kaito, Noboru Hosono, Yoshihiro Mukai, Takahiro Makino, Takeshi Fuji and Kazuo Yonenobu

. Possibly as a result of altered biomechanics at the adjacent mobile segments, ASD, a serious complication of PLIF, can occur. The actual cause of ASD, however, remains unknown. Some authors have attributed ASD to the altered biomechanical property due to immobilization of the fusion segment, 4 , 19 , 20 , 23 whereas others have argued that ASD is nothing more than a common aging process rather than a consequence of spinal fusion. 10 , 13 , 17 , 18 , 26 , 34 Several risk factors for the development of ASD have been proposed to date, such as the number of segments

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Jeong Yoon Park, Yong Eun Cho, Sung Uk Kuh, Jun Hyung Cho, Dong Kyu Chin, Byung Ho Jin and Keun Su Kim

biomechanical and clinical studies have been conducted to address superior-segment degeneration. 13 , 15 , 16 Although the development of ASD can be considered to be part of the normal aging and degenerative processes, it appears to be at least partly influenced by the altered stresses that arise as a consequence of lumbar fusion. The purpose of this study was to evaluate the correlation between ASD and pelvic parameters in patients with spondylolytic spondylolisthesis. Many risk factors for ASD have been studied. 4 , 14 Sagittal balance is the most important risk and

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Ming-Kai Hsieh, Fu-Cheng Kao, Wen-Jer Chen, I-Jung Chen and Sheng-Fen Wang

T he long-term clinical outcomes of spinal fusion in degenerative spondylolisthesis are influenced by a variety of pathophysiological factors such as the recurrence of spinal canal stenosis, instability, lumbar kyphosis, nonunion, and adjacent-segment degeneration (ASD). 15 The risk factors for ASD after short spinal fusion for degenerative spondylolisthesis include the aging process, sacrifice of the posterior ligament complex, excessive decompression during surgery, and poor sagittal balance after lumbar fusion. 7 Over the past 15 years, sagittal balance

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Jun-Hong Min, Jee-Soo Jang and Sang-Ho Lee

S pondylolisthesis , including the degenerative and isthmic types, in adults has been managed using various surgical options. Of these, PLIF and ALIF are among the most common. There have been many clinical analyses of the respective approaches, but there are not many comparative studies of approaches for managing spondylolisthesis. In addition, except for several biomechanical studies in which the authors have compared ALIF with posterolateral fusion, 1 , 14 comparative studies regarding the development of ASD in relation to each approach have been scarce

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Haichun Liu, Wenliang Wu, Yi Li, Jinwei Liu, Kaiyun Yang and Yunzhen Chen

L umbar fusion has increasingly become a standard treatment for spinal disorders during the past decades. 3 , 12 Degenerative lumbar disorders, including lumbar disc herniation, lumbar spinal stenosis, and spondylolisthesis, 13 have been noted as the most common indication for spinal fusion. 15 Although lumbar fusion results in high union rates and has yielded good clinical results in decreasing pain and paralysis, 5–8 it has also been associated with an increased incidence of ASD. 9 This pathology is now considered a potential late complication of

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Owoicho Adogwa, Scott L. Parker, David N. Shau, Stephen K. Mendenhall, Clinton J. Devin, Joseph S. Cheng and Matthew J. McGirt

F ailed back surgery syndrome is common, affecting 10%–40% of the patients who have previously undergone lumbosacral spine surgery. 7 , 15 A marked increase in lumbar spine surgery over the past 2 decades is well documented. 9 , 12 Adjacent-segment disease is a potential long-term complication of lumbar spine fusion. Management of patients with low-back and radicular pain secondary to ASD is costly and challenging to health care providers. 1 , 8 , 10 In this era of value-based purchasing, treatment cost is becoming an increasingly important component of

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Owoicho Adogwa, Ricardo K. Carr, Katherine Kudyba, Isaac Karikari, Carlos A. Bagley, Ziya L. Gokaslan, Nicholas Theodore and Joseph S. Cheng

Elderly patients requiring revision decompression and fusion for various etiologies of failed–back surgery syndrome (ASD, pseudarthrosis, and same-level recurrent stenosis) are a particularly difficult cohort to treat. Revision surgery can be technically challenging, and elderly patients often present with long durations of symptoms coupled with anxiety regarding surgeries that they believe have already failed. Moreover, the prevalence of medical comorbidities in this population makes the procedure even more complicated. Hence, outcomes after revision neural

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Sayf S. A. Faraj, Marinus De Kleuver, Alba Vila-Casademunt, Roderick M. Holewijn, Ibrahim Obeid, Emre Acaroğlu, Ahmet Alanay, Frank Kleinstück, Francisco S. Pérez-Grueso and Ferran Pellisé

T he leading cause of years lived with disability in Western societies continues to be low-back pain. 24 Adult spinal deformity (ASD), a condition referring to abnormal spinal curvatures among adults, constitutes one of the known causes of severe functional disability and back pain in the elderly. 1 , 16 Subsequently, ASD significantly reduces the overall quality of life in patients with a symptomatic deformity and is one of the most frequent indications for spine surgery. 19 An emphasis on healthy aging combined with rising life expectancies and recognition