Radiographic Adjacent Segment Degeneration at 5 Years After L4/5 Posterior Lumbar Interbody Fusion With Pedicle Screw Instrumentation

Abstract

R-ASD was detected more frequently by CT and MRI compared with radiography. Preoperative facet joint degeneration and morphology were not always related to progressive disk degeneration or spinal stenosis. Annual MRI suggested that accelerated degeneration was due to lumbar spine fusion, rather than aging degeneration. Decompression with preservation of posterior connective components is recommended to prevent R-ASD.