What diseases do back surgery patients have? Causes and treatment of adjacent node degenerationSpinal neurosurgeon Byung Woo Kim

Spinal fusion is a surgical procedure in which a cage (implant) is inserted between the vertebrae to maintain the spacing between the vertebrae and attach the bones above and below. The process of degeneration, in which the movement of the spinal nodes that have undergone fusion decreases and the disease increases to adjacent areas, is called 'adjacent node degeneration'. It is important to note that this degeneration of adjacent nodes does not occur in just one place, but can occur simultaneously.

Naturally healed discs take a long time to develop adjacent node degeneration, but fusion surgery can occur within 5 years, and up to 30% of patients who undergo surgery have been reported to develop the disease.

Because of this, you may need to have a second surgery after fusion, and it may happen again after surgery, so you may need to perform multiple spinal surgeries.

2. Causes of Adjacent Nodal Degeneration

Why does adjacent node degeneration occur?

When spinal surgery causes excessive load on adjacent nodes, spinal movement and lordosis* are reduced, resulting in or worsening degenerative diseases. If there are risk factors, they will occur faster and more severely. Risk factors for degeneration include the wide range of fusion, the special area of fusion, changes in the lordosis* of the spine, and osteoporosis and comorbidities.

*Lordosis: The degree of spinal alignment that curves forward

3. Treatment of adjacent node degeneration

How is adjacent node degeneration treated?

he treatment of adjacent node degeneration is the same as that of a general degenerative disease, but depends on the site of the lesion. Adjacent node degeneration is the primary diagnosis of imaging. Even if it is observed imagingly, it does not necessarily need to be treated. If the patient does not have pain or symptoms of nerve root compression, follow-up examinations can be performed every 6 months to 1 year without treatment.

If symptoms occur and treatment is required, non-surgical treatment or surgical treatment may be carried out depending on the progression.

Non-surgical treatments include medication, physical therapy, and procedures such as nerve therapy and nerve injections.

Surgical treatment may include fusion prolongation and endoscopic decompression. Fusion lengthening is performed when the spine is lowered, and endoscopic decompression is performed when the spine is lower.