You might be at risk for neighboring segment degeneration if you're thinking about having spinal fusion surgery for a degenerative disc or another issue (ASD). Extra wear and tear on the spinal joints above and below the fusion site is known as ASD. Here are five typical causes of ASD risk.
1. Reason for Your Back Surgery
You may have a higher risk of ASD depending on the diagnosis that prompts your back surgery.
ASD risk is higher in people who had spinal fusions to treat degenerative disc disease. This is because, despite the fact that you might not have felt symptoms, deterioration has already begun in the layers above and below the problematic area. The surgeon typically does not fuse those nearby levels.
ASD risk may also be higher in people with severe arthritis. Patients with severe arthritis have reduced residual capacity, which limits their margin for mistakes and makes them more vulnerable to additional spinal degeneration.
2. Your Age
It is commonly acknowledged that age significantly affects the risk for ASD.
The notion that back surgery promotes ASD is complicated by the degenerative nature of our spines as we age.
When pinpointing the origin of ASD, the natural progression of degenerative changes in the spine is a complicating factor. Your spine may already be experiencing these changes at more than one level, with or without surgery.
3. Location of Your Spine Surgery
You can stay balanced while moving because of the opposing curves in your spine. These curves are separated into the cervical (neck), thoracic (upper and middle back), lumbar (low back), and sacral area. Your risk for ASD may be increased if your surgery is performed where one curve merges into another, such as when the thoracic merges into the lumbar (T12-L1).
Fusions at active motion portions frequently lead to issues down the road. This is due to the possibility that such a fusion may increase the load on the nearby intervertebral joints, which could therefore raise the risk of adjacent segment illness and ASD.
4. Duration of the Fusion
In general, the more levels that are fused, the higher your risk for ASD.
ASD is more likely to occur in patients with spinal issues that require a lengthy fusion. An illustration of this is scoliosis. It's likely that over time, you'll develop ASD at T4-5 and L5-S1 if you're fused from T4-L4 (the range of motion segments, or intervertebral joints, that extend from the middle of your chest to just below your belly button) to treat scoliosis. The motion segments right above and below T4 and L4 are T4-5 and L5-S1, respectively.
5. Posture Before and During Your Back Surgery
Your posture and the positioning of your bones throughout the procedure could influence your likelihood of developing ASD. Your facet joints may later become stressed if you already have a kyphosis at the time of the fusion. Along with the degenerative changes characteristic of ASD, this could cause pain. The facet joints in the spine may develop spinal arthritis as a result.
There are two postural misalignments that are connected to the emergence of degenerative spinal alterations and ASD. The muscles that keep you upright may tire more quickly after surgery if your posture causes your pelvis to be tilted back during it. This could cause degenerative changes and pain in that region of your spine over time.
Additionally, the position of your sacrum during surgery matters. The crest of the sacrum would often lean somewhat forward. Your risk for ASD may be enhanced if your sacrum is in a vertical or nearly vertical posture throughout the procedure.
Do you have a forward head position, too? If so, your chance of ASD may increase again if you're undergoing a spinal fusion.
Remember that you carry your posture to the operating table even if some of these problems can and should be corrected by the surgeon at the time of the procedure.
Many of us develop our posture over time as a result of our habits, while others have it as a natural part of their structure. Before having the surgery, consulting a physical therapist for a home exercise program may help you reduce some of your risk of ASD if your kyphosis, forward head, sacral angle, and/or pelvic tilt-related posture issues are not ingrained in your bones.
