Welcome to this informative podcast episode with Dr. Tony Mork, a board-certified orthopedic surgeon. Today, Dr. Mork will discuss adjacent segment disease (ASD) following spinal fusion surgery. He will share the story of a patient who underwent a successful fusion 10 years ago but has recently experienced increasing back, buttock, and leg pain, which has significantly impacted his active lifestyle and forced him to give up racquetball.
Dr. Mork will walk listeners through the patient's MRI scans, explaining the various findings such as the darkening and narrowing of the disc, disc bulging, and overgrowth of bone tissue above the fusion level. He will also highlight the significant enlargement of the facet joints, a common pathological occurrence in ASD, and the resulting compression of the spinal cord.
In this comprehensive episode, Dr. Mork will delve into the long-term studies on ASD, discussing the potential consequences of spinal fusion in different populations. While fusion has been proven to be an effective treatment for degenerative spondylolisthesis, its use in younger patients and for an expanding range of indications raises questions about the possible long-term effects on certain cases and populations.
Dr. Mork will review the existing literature on fusion and decompression outcomes, highlighting both the satisfactory results and the challenges faced by some patients. He will also explore the factors contributing to ASD, such as increased mechanical stress on adjacent segments and the accelerated degeneration of adjacent discs and facet joints. He will discuss various considerations for preventing or mitigating the risk of ASD, including patient selection, surgical techniques, and the role of motion preservation technologies in potentially reducing ASD incidence.
Moreover, we'll examine the options for managing ASD, ranging from conservative treatments like physical therapy and pain management to surgical interventions.
I'm Dr. Tony Mork and I run an Endoscopic Spine Surgery practice in Irvine, California and Naples, FL. I avoid a fusion when possible (which is most situations) and provide treatments that actually address the pain without taking an invasive approach.
Some of the conditions I treat:
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