Revision surgery for pseudarthrosis or adjacent segment disease. Medical search. Frequent questions

OBJECT: Despite advances in technology and understanding in spinal physiology, reoperation for symptomatic adjacent-segment disease (ASD), same-level recurrent stenosis, and pseudarthrosis in elderly patients continues to occur. (duke.edu)
Lumbar TDA was developed as an alternative to fusion with the theoretical advantage of reducing rates of adjacent segment pathology and reoperation. (medscape.com)
The theoretical advantage of lumbar TDA is that it restores disc height and alleviates pain without eliminating motion at the diseased segment, which may minimize rates of reoperation due to ASP. (medscape.com)
and (3) the frequency of reoperation at the adjacent levels. (springer.com)
the adjacent-segment degeneration and pseudarthrosis were the most common reasons for reoperation. (springer.com)
24 ] reported adjacent segments underwent surgical treatment at an annual rate of 2% after cervical fusion and predicted that 22% of patients would need a reoperation for adjacent-segment degeneration within 10 years. (springer.com)

As a result, long-term complications include degeneration at these adjacent spine segments. (wikipedia.org)
As utilization of spinal fusion has increased over the past decade, so has the incidence of adjacent-segment degeneration following index lumbar fusion, which commonly requires revision laminectomy and extension of fusion. (unboundmedicine.com)
1,2 Lumbar decompression and fusion surgery is well established as a treatment for degenerative spine pathology, including disc degeneration, spondylosis, and spondylolisthesis. (ijssurgery.com)
Anterior cervical discectomy and fusion is a standard surgical treatment for cervical radiculopathy and myelopathy, but reoperations sometimes are performed to treat complications of fusion such as pseudarthrosis and adjacent-segment degeneration. (springer.com)
Despite its widespread acceptance, reoperations may be required to treat complications of fusion such as pseudarthrosis and adjacent-segment degeneration. (springer.com)
21 ] reported symptomatic adjacent-segment degeneration occurred with an annual risk of 3% after anterior cervical discectomy and fusion. (springer.com)
Adjacent Segment Degeneration and Disease of the Cervical Spine 59. (acco.be)
Multi-segmental lumbar degenerative disease, including intersegmental disc degeneration, is found in clinical practice. (bvsalud.org)
Controversy still exists regarding the treatment for cross-segment degeneration. (bvsalud.org)

Scholars@Duke publication: Revision lumbar surgery in elderly patients with symptomatic pseudarthrosis, adjacent-segment disease, or same-level recurrent stenosis. (duke.edu)
To date, an analysis of the cost and health state gain associated with revision lumbar surgery in elderly patients with symptomatic pseudarthrosis, ASD, or same-level recurrent lumbar stenosis has yet to be performed. (duke.edu)
METHODS: After reviewing their institutional database, the authors found 69 patients 65 years of age and older who had undergone revision decompression and instrumented fusion for back and leg pain associated with pseudarthrosis (17 patients), same-level recurrent stenosis (24 patients), or ASD (28 patients) and included them in this study. (duke.edu)
CONCLUSIONS: Revision decompression and fusion provided a significant gain in health state utility for elderly patients with symptomatic pseudarthrosis, same-level recurrent stenosis, or ASD, with a mean 2-year cost of $80,594 per QALY gained. (duke.edu)
When indicated, revision surgery for symptomatic ASD, same-level recurrent stenosis, and pseudarthrosis is a valuable treatment option for elderly patients experiencing persistent back and leg pain. (duke.edu)
For example, in a randomized controlled trial of people with spinal stenosis, after 2 and 5 years there was no significant clinical benefits of lumbar fusion in combination with decompression surgery, in comparison to decompression surgery alone. (wikipedia.org)
Lumbar laminectomy , represents the standard operative treatment for lumbar spinal stenosis , but this procedure is often combined with fusion surgery. (neurosurgery.directory)
Dr. Aaron Clark is a neurosurgeon specializing in minimally invasive outpatient procedures for lumbar and cervical herniated discs and stenosis, as well as minimally invasive lumbar fusion surgery. (ucsf.edu)

The aim of this study was to assess the long-term outcomes and cost-effectiveness of revision surgery in elderly patients with recurrent or persistent back and leg pain. (duke.edu)
In 50 consecutive patients undergoing revision surgery for ASD-associated back and leg pain, PRO measures of back and leg pain on a visual analog scale (BP-VAS and LP-VAS, respectively), Oswestry Disability Index (ODI), 12-Item Short Form Health Survey Physical and Mental Component Summaries (SF-12 PCS and MCS, respectively), and EuroQol-5D health survey (EQ-5D) were assessed preoperatively and 2 years postoperatively. (unboundmedicine.com)

The objective of this study is to examine the short and long term impact of subsidence after anterior cervical discectomy and fusion for compressive cervical disc disease, utilizing solely non-locking stand-alone titanium cage and to analyze the fusion rates. (fortuneonline.org)

While revision lumbar surgery is effective, attention has turned to questions on the utility and value of the revision decompression and fusion procedure. (duke.edu)

In 2014, he completed a fellowship in minimally invasive spine surgery at the Semmes Murphey Neurologic and Spine Institute in Memphis, Tennessee, under the mentorship of Dr. Kevin Foley, a pioneer of minimally invasive spine surgery. (ucsf.edu)

Indications for this approach have expanded and now include degenerative disease, tumor, deformity, and infection. (surgicalneurologyint.com)

It can occur spontaneously or as a complication following trauma or surgery. (igeamedical.com)
Bone marrow edema is an abnormal accumulation of fluid within a skeletal segment that can occur as a result of trauma, joint diseases such as osteoarthritis, functional overload or even spontaneously, as occurs in the early stages of osteonecrosis . (igeamedical.com)
It is utilized for the treatment of a range of cervical spinal ailments, such as compressive myelopathy, herniated discs, degenerative disease, and trauma. (fortuneonline.org)
Three major routes of spread are: (1) hematogenous spread from a distant infection, (2) direct inoculation from trauma, (3) direct inoculation following invasive spinal diagnostic procedures and from spinal surgery. (wheelessonline.com)

These procedures are associated with shorter recovery times and less postoperative pain than standard surgeries, and almost all patients can return home the same day. (ucsf.edu)

Journal of Spine Research and Surgery 5 (2023): 51-57. (fortuneonline.org)

Infection places a patient at higher risk for non-fusion (pseudoarthrosis), chronic pain, revision surgery, neurological complications, and delayed recovery. (spine-health.com)

65 years old), osteoporotic patients undergoing multilevel fusion, and patients with multiple prior fusion surgeries. (ijssurgery.com)
The MDC approach with HTI anchor appears to be most appropriate for calculation of MCID after revision lumbar fusion for ASD because it provided a threshold above the 95% CI of the unimproved cohort (greater than the measurement error), was closest to the mean change score reported by improved and satisfied patients, and was not significantly affected by choice of anchor. (unboundmedicine.com)
Patients without previous surgery benefited significantly better, whereas patients with previous decompression benefited regarding back pain, especially for long-term follow-up with a clear trend in favor of leg pain 1) . (neurosurgery.directory)
The California Office of Statewide Health Planning and Development discharge database was queried for patients aged 18 to 65 years undergoing lumbar TDA and LF for degenerative disc disease from 2004 to 2010. (medscape.com)
Following spinal fusion surgery, patients may experience postsurgical complications during the recovery period. (spine-health.com)
Patient Frailty Influences Outcome After Open, But Not Minimally Invasive, Transforaminal Interbody Fusion: A Case Series of 115 Patients With Lumbar Degenerative Disease. (ucsf.edu)
Anterior cruciate ligament reconstruction surgeries, meniscus removal or suturing are widely used, especially among patients who play sports at any level. (igeamedical.com)
For instance, Robinson and McMaster reviewed 109 patients with juvenile idiopathic scoliosis and found that nearly 90% of curves progressed and that almost 70% of these patients went on to require surgery. (medscape.com)

1 Despite advancements in surgical techniques, approximately 10% to 40% of spine fusions fail, leading to failed back surgery ultimately requiring revision surgeries. (ijssurgery.com)
Fusions performed for degenerative disc disease, and associated diagnoses, have become increasingly common over the past 2 decades, increasing 220% from 1990 to 2001 and increasing 2.4-fold from 2000 to 2009. (medscape.com)
Despite the relative frequency with which they are performed, lumbar fusions have several potential issues, such as pseudarthrosis and adjacent segment pathology (ASP). (medscape.com)

4 clinics specializing in Orthopedic surgery providing treatment of Shoulder tendinitis Shoulder tendinitis is the inflammation of the tendons in the shoulder, commonly caused by overuse or repetitive movements. (doctor.global)

He completed his neurosurgery residency at UCSF, where he developed his interest in spine surgery and began publishing research on spinal oncology, spine biomechanics, spinal deformities and neurophysiological monitoring during spine surgery. (ucsf.edu)
He is an active member of American Association of Neurosurgery, North American Spine Surgery, Scoliosis Research Society, and Cervical Spine Research Society. (stanford.edu)

[ 5 ] Winter taught that idiopathic scoliosis is a hypokyphotic disease. (medscape.com)

2 The disease may occur from infancy to old age, but has a predilection for the elderly. (wheelessonline.com)

1 Li T, Shi L, Luo Y, Chen D, Chen Y. One-level or multilevel interbody fusion for multilevel lumbar degenerative diseases: a prospective randomized control study with a 4-year follow-up. (spine-health.com)

Scheuermann's disease) Lordosis Spondylolisthesis Spondylosis Posterior rami syndrome Other degenerative spinal conditions Any condition that causes instability of the spine Bone morphogenetic protein (rhBMP) should not be routinely used in any type of anterior cervical spine fusion, such as with anterior cervical discectomy and fusion. (wikipedia.org)

To examine complications and rates of subsequent surgery following lumbar spinal fusion (LF) and lumbar total disc arthroplasty (TDA) at up to 5-year follow-up. (medscape.com)
Nerve damage during lumbar spinal fusion surgery may cause leg numbness and weakness. (spine-health.com)
Nerve damage during a lumbar spinal fusion surgery can result in motor and sensory defects in the low back and legs, 3 Lykissas MG, Aichmair A, Hughes AP, Sama AA, Lebl DR, Taher F, Du JY, Cammisa FP, Girardi FP. (spine-health.com)
Bleeding during lumbar spinal fusion surgery may be associated with conditions such as spinal canal narrowing. (spine-health.com)
In a lumbar spinal fusion, a greater risk of bleeding during surgery is associated with 4 Huang YH, Ou CY. (spine-health.com)

Currently, there is interest in minimally invasive surgery and various technical modifications of decompressive lumbar laminectomy without fusion. (neurosurgery.directory)

These results suggest that in degenerative lumbar spine disease without isthmic spondylolisthesis, TLIF and PLF achieved similar outcomes. (ijssurgery.com)
3 Over time, increasing rates of lumbar spine surgery and improved outcomes have been observed, attributable to advances in surgical technique, such as the introduction of interbody fusion approaches. (ijssurgery.com)

It is also used as a backup procedure for total disc replacement surgery (intervertebral disc arthroplasty), in case patient anatomy prevents replacement of the disc. (wikipedia.org)
Your doctor will explain the surgical procedure, its risks and benefits, and answer all your other surgery-related queries before the procedure. (dallasspinesurgery.com)

Significant Blood Loss in Lumbar Fusion Surgery for Degenerative Spine. (spine-health.com)

Conditions where spinal fusion may be considered include the following: Degenerative disc disease Spinal disc herniation Discogenic pain Spinal tumor Vertebral fracture Scoliosis Kyphosis (e. g. (wikipedia.org)
20 43 44 ] The lateral transpsoas approach has been used in the management of adult degenerative disease as well as degenerative scoliosis. (surgicalneurologyint.com)
Scoliosis (abnormal curvature of the spine) represents a disturbance of an otherwise well-organized 25-member intercalated series of spinal segments. (medscape.com)

Dr Vishnu Vikraman Nair, FELLOW in Spine Surgery, Department of Orthopaedics, Bombay hospital and medical research institute. (fortuneonline.org)

[ 2 ] These complications can contribute to persistent lower back pain and costly revision surgeries. (medscape.com)

Spinal fusion is most commonly performed to relieve the pain and pressure from mechanical pain of the vertebrae or on the spinal cord that results when a disc (cartilage between two vertebrae) wears out (degenerative disc disease). (wikipedia.org)
LF is commonly used in the management of degenerative disc disease causing pain refractory to nonoperative management. (medscape.com)
Lumbar fusion (LF) is commonly performed for the treatment of severe degenerative disc disease (DDD) causing pain refractory to nonoperative management. (medscape.com)
The most common risk of a spine fusion surgery is the failure to relieve lower back pain symptoms following the surgery. (spine-health.com)
Lumbar degenerative disease resulting in low back pain and/or lower extremity radiculopathy is a potentially debilitating condition with increasing prevalence due to an aging population. (ijssurgery.com)
Complex Regional Pain Syndrome Type I, also called Algodystrophy, is a rare disease that begins with pain and swelling often localized in the hand or wrist, shoulder or foot. (igeamedical.com)

Oblique Lateral Interbody Fusion (OLIF) with several internal fixations was used to treat cross-segment lumbar degenerative disease. (bvsalud.org)

This outcome is commonly referred to as failed back surgery syndrome . (spine-health.com)

Particularly, depression has been shown to be associated with less improvement following lumbar fusion surgery 2) 3) 4) 5) 6) 7) 8) . (neurosurgery.directory)

Findings in this study provided a value measure of surgery that can be compared with future cost-per-QALY-gained studies of medical management or alternative surgical approaches. (duke.edu)

Osteoarthritis is a chronic degenerative disease that involves the entire joint structure characterised by a progressive deterioration of cartilage, synovial tissue (the membrane that surrounds the joint), the subchondral bone (underneath the cartilage) and the joint capsule. (igeamedical.com)

RESULTS: The mean (± standard deviation) time between the index surgery and revision surgery was 3.51 ± 3.63 years. (duke.edu)

The most common cause of pressure on the spinal cord/nerves is degenerative disc disease. (wikipedia.org)
Spine infections are rare infections that can involve the intervertebral disc space (discitis), the vertebral bones, the spinal canal or adjacent soft tissues. (wheelessonline.com)

With decompressive surgery and proactive interventions to improve spinal cord perfusion, early treatment has become more intensive. (neurosurgery.directory)

Revision decompression and extension of fusion was associated with a mean 2-year cost of $80,594 per QALY gained. (duke.edu)

These complications can range from minor issues that may be resolved during surgery to more serious complications that require additional interventions. (spine-health.com)

Rates of repeat lumbar surgery were calculated at 90-day and 1-, 3-, and 5-year follow-up intervals. (medscape.com)
However, there were no differences in rates of subsequent lumbar surgery between the 2 groups at 3-year and 5-year follow-up. (medscape.com)
Complications in Spine Surgery: Expected Rates and Classification Part 2: Pathophysiology of Spinal Disorders Section 2.1: Pathophysiology of Congenital and Developmental Disorders 18. (acco.be)

They've also revealed latent disease-modifying factors, helped develop clinical trial stratification models and served as matched control groups in clinical trials. (neurosurgery.directory)

You will have a preoperative assessment session before surgery. (dallasspinesurgery.com)

Once the disease is recognized, effective ways exist to treat it. (medscape.com)

Additionally, female sex and low levels of hemoglobin prior to the surgery may increase the risk of blood loss during surgery. (spine-health.com)

Anatomy17

Diseases19

Chemicals and Drugs4

Analytical, Diagnostic and Therapeutic Techniques and Equipment32

Phenomena and Processes7

Technology, Industry, Agriculture4

Health Care3

Reoperation6

Degeneration9

Stenosis8

Back and leg pain2

Cervical disc1

Decompression and fusion1

Minimally invasive spine1

Deformity1

Trauma4

Procedures1

20231

Pseudoarthrosis1

Patients8

Fusions3

Orthopedic Surgery1

Neurosurgery2

Idiopathic Scoliosis1

Occur1

Multilevel1

Anterior1

Lumbar spinal fusion5

Laminectomy1

Outcomes2

Procedure2

Degenerative Spine1

Scoliosis3

Orthopaedics1

Persistent1

Pain6

Interbody1

Failed back sur1

Fusion surgery1

Surgical1

Chronic1

Index1

Disc2

Spinal cord1

Extension of fusion1

Interventions1

Rates3

Clinical1

Assessment1

Treat1

Levels1