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Understanding Adjacent Segment Disease Following Spinal Fusion Surgery in Workers' Comp Patients

Posted by James Aspell | Oct 28, 2023 | 0 Comments

The human spine is a remarkable structure, composed of vertebrae, discs, and intricate networks of nerves. It provides the foundation for our movement, flexibility, and stability. However, it's also susceptible to injuries, especially in high-risk occupational settings. Among the various complications that can arise from spinal injuries, Adjacent Segment Disease (ASD) after spinal fusion surgery is one that requires particular attention, especially within the workers' compensation space. In this article, we'll delve deeply into understanding ASD, its link with spinal fusion surgeries, and its implications for workers' comp patients.

Image of spine showing spinal fusion hardware and diseased disc segments above the fusion site

1. What is Adjacent Segment Disease (ASD)?

Adjacent Segment Disease is a condition where the vertebral segments immediately above or below a spinal fusion site show signs of degeneration. This can occur after a patient has undergone spinal fusion surgery, which joins two or more vertebrae to stabilize the spine. While the fused segment becomes rigid, the adjacent segments bear additional stress, leading to degeneration and potential complications.

2. The Anatomy of the Spine and the Role of Spinal Fusion

To appreciate the complexity of ASD, we must first understand the spine's basic anatomy. The spine consists of 33 vertebrae, cushioned by intervertebral discs. These discs absorb shocks and enable flexibility. Spinal fusion is a surgical technique used to join two or more of these vertebrae. While it alleviates pain and restores stability, it does render the fused segment immobile.

3. Causes of Adjacent Segment Disease

ASD's primary cause is the altered biomechanics of the spine after fusion surgery. Some of the key factors include:

  • Increased Load on Adjacent Segments: After fusion, the adjacent segments experience increased mechanical stress.
  • Natural Aging Process: Degeneration can also be part of the spine's natural aging process, accelerated by the surgery.
  • Surgical Techniques: The method and level of fusion can influence the risk of developing ASD.

4. Symptoms and Diagnosis of ASD

Patients with Adjacent Segment Disease might experience:

  • Pain at the level above or below the fused segment
  • Numbness or tingling in the extremities
  • Limited range of motion

Diagnosing ASD involves radiological tests, like X-rays or MRIs, to identify degenerative changes in the adjacent segments.

5. Implications for Workers' Comp Patients

Workers' compensation patients have unique concerns. They often suffer from spinal injuries due to work-related incidents, and their recovery trajectory determines their return to work. Here are the implications of ASD for these patients:

  • Extended Recovery Time: ASD can prolong recovery, impacting the patient's ability to return to work.
  • Increased Medical Costs: Additional treatments or surgeries for ASD can escalate medical bills.
  • Long-Term Disability: In severe cases, ASD can result in prolonged disability, affecting the worker's earning potential.
  • Entitlement to Additional Workers Comp Benefits: In Connecticut, if you have an accepted workers compensation claim, and you suffer adjacent segment disease related to your original work injury, you are entitled to additional benefits and compensation on account of the worsening of your condition.

6. Management and Treatment Options

Early detection and intervention are crucial. Some of the prevalent treatment options are:

  • Conservative Management: This includes physical therapy, pain management, and lifestyle modifications.
  • Surgical Intervention: In cases where conservative treatments fail, surgical procedures, like a revision spinal fusion, may be necessary.

7. Prevention is Better than Cure

While it's not always possible to prevent ASD, certain strategies can minimize its risk:

  • Optimal Surgical Techniques: Choosing the right surgical technique and fusion level can reduce the stress on adjacent segments.
  • Post-Surgical Rehabilitation: A structured rehabilitation program post-surgery can aid in evenly distributing spinal loads.
  • Ergonomic Practices: For workers' comp patients, ergonomic workplace practices can mitigate the risk of recurrent spinal injuries.

In Conclusion

Adjacent Segment Disease following spinal fusion surgery is a significant concern, especially for workers' compensation patients. While the spine's altered biomechanics post-surgery predominantly cause it, factors like aging, surgical techniques, and post-surgical rehabilitation play pivotal roles. For workers' comp patients, the implications of ASD extend beyond physical pain – it impacts their recovery trajectory, medical costs, and long-term earning potential. As with most medical conditions, prevention, early detection, and timely intervention are paramount in managing ASD. If you have a Connecticut work injury case, and are now experiencing new or increased back pain, call us today to discuss your options for additional compensation.


About the Author

James Aspell

Principal since August 1, 2006 James F. Aspell is the principal and managing attorney of the firm which he started in 2006 following 20 years of litigation practice in a mid -size firm in Hartford, Connecticut. Jim focuses his practice in the areas of worker's compensation and personal injury l...


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