Adjacent Segment Disease: A Complication?

One of the most enduring controversies of spine surgery has been the question of propagation of disc degeneration beyond a single disc level into other adjacent motion segments. Undoubtedly there is a strong, inherent propensity of some patients to develop disc degeneration in more than one level. What is the role of surgical intervention in potentially propagating this process to other levels -- be it through decompression surgery, fusion or arthroplasty surgery?
These are important considerations not only for patients and their health care providers, but also for insurers and health care rating agencies as reoperations in spine surgery have become an important evaluation point. Dr. Lee from the University of Washington and Visiting Professor Dr. McGuire from the University of Mississippi provide their respective views on this topic.
Robert A. McGuire, MD, Michael J. Lee, MD
9/30/2011