{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T15:26:41Z","timestamp":1793978801799,"version":"4.8.0"},"reference-count":45,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,2,27]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>Lumbosacral or lumbo-iliac fusion may be warranted in patients with symptomatic diffuse lumbar spondylosis or mild to moderate lumbar spinal deformity. Depending on the extent of pathology, the L2 vertebra may be chosen as the uppermost instrumented vertebra (UIV) to avoid fusion crossing the thoracolumbar junction. However, the incidence of adjacent segment degeneration (ASD) following L2 to sacrum or ilium fusion has not been well studied. The authors aimed to determine the incidence of ASD following instrumented fusion in adult patients undergoing L2 to sacrum or ilium fusion and to identify the risk factors for this complication.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>The medical records of adult patients who underwent decompression and lumbosacral or lumbo-iliac instrumented fusion for diffuse lumbar spondylosis, degenerative scoliosis, or sagittal malalignment with L2 as the UIV between January 2016 and December 2023 were retrospectively reviewed. ASD is defined as the progression of disc degeneration, worsening of spinal stenosis, junctional kyphosis, UIV or UIV+1 compression fracture, and screw pullout or loosening that caused pain or neurological deficits. The incidence of ASD was analyzed. Kaplan-Meier analysis was used to evaluate symptomatic ASD-free survival. Univariate and multivariate logistic regression were used to assess potential risk factors, including patient-related factors, surgery-related factors, and pre- and postoperative spinopelvic parameters.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Eighty-nine patients (57 males, 32 females; mean age 68.5 years) were included. The mean duration of follow-up was 38.6 months. Thirty-six (40%) patients developed symptomatic ASD, and 21 (23.6%) required reoperation. Simultaneous decompression at L2\u20133, preexisting L1\u20132 disc degeneration, greater postoperative pelvic incidence\u2013lumbar lordosis (PI-LL) mismatch, and higher lordosis distribution index were risk factors for the development of ASD. Twelve (13.5%) patients developed distal failure, including 9 pseudarthroses at L5\u2013S1, 2 sacral fractures, and 1 rod fracture between S1 and the iliac screw. Male sex, young age, and lack of iliac screws were risk factors for distal failure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>These findings suggest that the overall incidence of ASD is high in adult patients with lumbar degeneration or spinal deformity who undergo instrumented fusion from L2 to the sacrum or ilium. Significant risk factors for developing ASD include simultaneous decompression at L2\u20133, preexisting advanced disc degeneration at L1\u20132, greater postoperative PI-LL mismatch, and higher lordosis distribution index.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2025.8.spine25770","type":"journal-article","created":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T11:44:53Z","timestamp":1772192693000},"page":"693-703","source":"Crossref","is-referenced-by-count":0,"title":["Incidence and risk factors of adjacent segment degeneration in lumbosacral or lumbo-iliac fusion with L2 as the uppermost instrumented vertebra"],"prefix":"10.3171","volume":"44","author":[{"given":"Chun-Po","family":"Yen","sequence":"first","affiliation":[{"name":"Department of Neurological Surgery, University of Virginia, Charlottesville, Virginia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian J.","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Virginia, Charlottesville, Virginia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Ben-Israel","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Virginia, Charlottesville, Virginia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rakesh","family":"Kumar","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Virginia, Charlottesville, Virginia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hong Joo","family":"Moon","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Virginia, Charlottesville, Virginia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justin S.","family":"Smith","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Virginia, Charlottesville, Virginia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"17","key":"b1","series-title":"Spine (Phila Pa 1976)","first-page":"1938","article-title":"Adjacent segment disease after lumbar or lumbosacral fusion: review of the literature","volume":"29","author":"Park P","year":"2004","unstructured":"Park P, Garton HJ, Gala VC, Hoff JT, McGillicuddy JE. Adjacent segment disease after lumbar or lumbosacral fusion: review of the literature. Spine (Phila Pa 1976). 2004;29(17):1938\u20131944. doi:10.1097\/01.brs.0000137069.88904.03"},{"issue":"6","key":"b2","series-title":"Spine (Phila Pa 1976)","first-page":"574","article-title":"Lumbosacral spinal fusion. A biomechanical study","volume":"9","author":"Lee CK","year":"1984","unstructured":"Lee CK, Langrana NA. Lumbosacral spinal fusion. A biomechanical study. Spine (Phila Pa 1976). 1984;9(6):574\u2013581. doi:10.1097\/00007632-198409000-00007"},{"issue":"2","key":"b3","series-title":"J Spinal Disord","first-page":"99","article-title":"Effect of immobilization and configuration on lumbar adjacent-segment biomechanics","volume":"6","author":"Ha KY","year":"1993","unstructured":"Ha KY, Schendel MJ, Lewis JL, Ogilvie JW. Effect of immobilization and configuration on lumbar adjacent-segment biomechanics. J Spinal Disord. 1993;6(2):99\u2013105."},{"issue":"15","key":"b4","series-title":"Spine (Phila Pa 1976)","first-page":"1745","article-title":"Comparison of in vivo and in vitro adjacent segment motion after lumbar fusion","volume":"19","author":"Dekutoski MB","year":"1994","unstructured":"Dekutoski MB, Schendel MJ, Ogilvie JW, Olsewski JM, Wallace LJ, Lewis JL. Comparison of in vivo and in vitro adjacent segment motion after lumbar fusion. Spine (Phila Pa 1976). 1994;19(15):1745\u20131751. doi:10.1097\/00007632-199408000-00015"},{"issue":"2","key":"b5","series-title":"J Bone Joint Surg Br","first-page":"289","article-title":"Intervertebral disc degeneration adjacent to a lumbar fusion. An experimental rabbit model","volume":"84","author":"Phillips FM","year":"2002","unstructured":"Phillips FM, Reuben J, Wetzel FT. Intervertebral disc degeneration adjacent to a lumbar fusion. An experimental rabbit model. J Bone Joint Surg Br. 2002;84(2):289\u2013294. doi:10.1302\/0301-620x.84b2.11937"},{"issue":"17","key":"b6","series-title":"Spine (Phila Pa 1976)","first-page":"1873","article-title":"Magnetic resonance classification of lumbar intervertebral disc degeneration","volume":"26","author":"Pfirrmann CW","year":"2001","unstructured":"Pfirrmann CW, Metzdorf A, Zanetti M, Hodler J, Boos N. Magnetic resonance classification of lumbar intervertebral disc degeneration. Spine (Phila Pa 1976). 2001;26(17):1873\u20131878. doi:10.1097\/00007632-200109010-00011"},{"issue":"21","key":"b7","series-title":"Spine (Phila Pa 1976)","first-page":"1919","article-title":"Qualitative grading of severity of lumbar spinal stenosis based on the morphology of the dural sac on magnetic resonance images","volume":"35","author":"Schizas C","year":"2010","unstructured":"Schizas C, Theumann N, Burn A,  Qualitative grading of severity of lumbar spinal stenosis based on the morphology of the dural sac on magnetic resonance images. Spine (Phila Pa 1976). 2010;35(21):1919\u20131924. doi:10.1097\/BRS.0b013e3181d359bd"},{"issue":"6 suppl","key":"b8","series-title":"Spine J","first-page":"190S","article-title":"Adjacent segment degeneration and adjacent segment disease: the consequences of spinal fusion?","volume":"4","author":"Hilibrand AS","year":"2004","unstructured":"Hilibrand AS, Robbins M. Adjacent segment degeneration and adjacent segment disease: the consequences of spinal fusion? Spine J. 2004;4(6 suppl):190S\u2013194S. doi:10.1016\/j.spinee.2004.07.007"},{"issue":"15","key":"b9","series-title":"Spine (Phila Pa 1976)","first-page":"1701","article-title":"Lumbar adjacent segment degeneration and disease after arthrodesis and total disc arthroplasty","volume":"33","author":"Harrop JS","year":"2008","unstructured":"Harrop JS, Youssef JA, Maltenfort M,  Lumbar adjacent segment degeneration and disease after arthrodesis and total disc arthroplasty. Spine (Phila Pa 1976). 2008;33(15):1701\u20131707. doi:10.1097\/BRS.0b013e31817bb956"},{"issue":"7","key":"b10","series-title":"J Bone Joint Surg Am","first-page":"1497","article-title":"Adjacent segment degeneration in the lumbar spine","volume":"86","author":"Ghiselli G","year":"2004","unstructured":"Ghiselli G, Wang JC, Bhatia NN, Hsu WK, Dawson EG. Adjacent segment degeneration in the lumbar spine. J Bone Joint Surg Am. 2004;86(7):1497\u20131503. doi:10.2106\/00004623-200407000-00020"},{"issue":"1","key":"b11","series-title":"Spine J","first-page":"11","article-title":"Incidence and prevalence of surgery at segments adjacent to a previous posterior lumbar arthrodesis","volume":"11","author":"Sears WR","year":"2011","unstructured":"Sears WR, Sergides IG, Kazemi N, Smith M, White GJ, Osburg B. Incidence and prevalence of surgery at segments adjacent to a previous posterior lumbar arthrodesis. Spine J. 2011;11(1):11\u201320. doi:10.1016\/j.spinee.2010.09.026"},{"issue":"16","key":"b12","series-title":"Spine (Phila Pa 1976)","first-page":"2471","article-title":"The effects of immobilization of long segments of the spine on the adjacent and distal facet force and lumbosacral motion","volume":"18","author":"Nagata H","year":"1993","unstructured":"Nagata H, Schendel MJ, Transfeldt EE, Lewis JL. The effects of immobilization of long segments of the spine on the adjacent and distal facet force and lumbosacral motion. Spine (Phila Pa 1976). 1993;18(16):2471\u20132479. doi:10.1097\/00007632-199312000-00017"},{"issue":"8","key":"b13","series-title":"Eur Spine J","first-page":"1175","article-title":"A prospective randomised study on the long-term effect of lumbar fusion on adjacent disc degeneration","volume":"18","author":"Ekman P","year":"2009","unstructured":"Ekman P, M\u00f6ller H, Shalabi A, Yu YX, Hedlund R. A prospective randomised study on the long-term effect of lumbar fusion on adjacent disc degeneration. Eur Spine J. 2009;18(8):1175\u20131186. doi:10.1007\/s00586-009-0947-3"},{"key":"b14","series-title":"J Orthop Surg Res","first-page":"97","article-title":"Risk factors for predicting symptomatic adjacent segment degeneration requiring surgery in patients after posterior lumbar fusion","volume":"9","author":"Liang J","year":"2014","unstructured":"Liang J, Dong Y, Zhao H. Risk factors for predicting symptomatic adjacent segment degeneration requiring surgery in patients after posterior lumbar fusion. J Orthop Surg Res. 2014;9:97. doi:10.1186\/s13018-014-0097-0"},{"issue":"1 suppl","key":"b15","series-title":"Orthop Traumatol Surg Res","first-page":"S1","article-title":"Degenerative disease supra- and infra-jacent to fused lumbar and lumbo-sacral levels","volume":"102","author":"Rousseau MA","year":"2016","unstructured":"Rousseau MA, Lazennec JY. Degenerative disease supra- and infra-jacent to fused lumbar and lumbo-sacral levels. Orthop Traumatol Surg Res. 2016;102(1 suppl):S1\u20138. doi:10.1016\/j.otsr.2015.12.003"},{"issue":"20","key":"b16","series-title":"Spine (Phila Pa 1976)","first-page":"2253","article-title":"Adjacent segment disease followinglumbar\/thoracolumbar fusion with pedicle screw instrumentation: a minimum 5-year follow-up","volume":"32","author":"Cheh G","year":"2007","unstructured":"Cheh G, Bridwell KH, Lenke LG,  Adjacent segment disease followinglumbar\/thoracolumbar fusion with pedicle screw instrumentation: a minimum 5-year follow-up. Spine (Phila Pa 1976). 2007;32(20):2253\u20132257. doi:10.1097\/BRS.0b013e31814b2d8e"},{"issue":"5","key":"b17","series-title":"J Orthop Sci","first-page":"490","article-title":"Adjacent segment stenosis after lumbar fusion requiring second operation","volume":"10","author":"Aiki H","year":"2005","unstructured":"Aiki H, Ohwada O, Kobayashi H,  Adjacent segment stenosis after lumbar fusion requiring second operation. J Orthop Sci. 2005;10(5):490\u2013495. doi:10.1007\/s00776-005-0919-3"},{"issue":"3","key":"b18","series-title":"Acta Orthop Scand","first-page":"269","article-title":"AP-translation in the proximal disc adjacent to lumbar spine fusion. A retrospective comparison of mono- and polysegmental fusion in 120 patients","volume":"68","author":"Wimmer C","year":"1997","unstructured":"Wimmer C, Gluch H, Krismer M, Ogon M, Jesenko R. AP-translation in the proximal disc adjacent to lumbar spine fusion. A retrospective comparison of mono- and polysegmental fusion in 120 patients. Acta Orthop Scand. 1997;68(3):269\u2013272. doi:10.3109\/17453679708996699"},{"issue":"4","key":"b19","series-title":"Neurosurgery","first-page":"396","article-title":"Impact of body mass index on adjacent segment disease after lumbar fusion for degenerative spine disease","volume":"76","author":"Ou CY","year":"2015","unstructured":"Ou CY, Lee TC, Lee TH, Huang YH. Impact of body mass index on adjacent segment disease after lumbar fusion for degenerative spine disease. Neurosurgery. 2015;76(4):396\u2013401.discussion 401-402. doi:10.1227\/NEU.0000000000000627"},{"issue":"2","key":"b20","series-title":"J Bone Metab","first-page":"114","article-title":"Systematic review and meta-analysis of the effect of osteoporosis on reoperation rates and complications after surgical management of lumbar degenerative disease","volume":"31","author":"Lechtholz-Zey EA","year":"2024","unstructured":"Lechtholz-Zey EA, Ayad M, Gettleman BS,  Systematic review and meta-analysis of the effect of osteoporosis on reoperation rates and complications after surgical management of lumbar degenerative disease. J Bone Metab. 2024;31(2):114\u2013131. doi:10.11005\/jbm.2024.31.2.114"},{"issue":"23","key":"b21","series-title":"Spine (Phila Pa 1976)","first-page":"E1588","article-title":"Effects of restoration of sagittal alignment on adjacent segment degeneration in instrumented lumbar fusions","volume":"45","author":"Kim SI","year":"2020","unstructured":"Kim SI, Min HK, Ha KY,  Effects of restoration of sagittal alignment on adjacent segment degeneration in instrumented lumbar fusions. Spine (Phila Pa 1976). 2020;45(23):E1588\u2013E1595. doi:10.1097\/BRS.0000000000003682"},{"issue":"11","key":"b22","series-title":"Eur Spine J","first-page":"1951","article-title":"Adjacent segment degeneration after instrumented posterolateral lumbar fusion: a prospective cohort study with a minimum five-year follow-up","volume":"20","author":"Anandjiwala J","year":"2011","unstructured":"Anandjiwala J, Seo JY, Ha KY, Oh IS, Shin DC. Adjacent segment degeneration after instrumented posterolateral lumbar fusion: a prospective cohort study with a minimum five-year follow-up. Eur Spine J. 2011;20(11):1951\u20131960. doi:10.1007\/s00586-011-1917-0"},{"issue":"11","key":"b23","series-title":"Eur Spine J","first-page":"1637","article-title":"Risk factors for adjacent segment disease after lumbar fusion","volume":"18","author":"Lee CS","year":"2009","unstructured":"Lee CS, Hwang CJ, Lee SW,  Risk factors for adjacent segment disease after lumbar fusion. Eur Spine J. 2009;18(11):1637\u20131643. doi:10.1007\/s00586-009-1060-3"},{"issue":"14","key":"b24","series-title":"Spine (Phila Pa 1976)","first-page":"1535","article-title":"Risk factors for adjacent segment degeneration after PLIF","volume":"29","author":"Okuda S","year":"2004","unstructured":"Okuda S, Iwasaki M, Miyauchi A, Aono H, Morita M, Yamamoto T. Risk factors for adjacent segment degeneration after PLIF. Spine (Phila Pa 1976). 2004;29(14):1535\u20131540. doi:10.1097\/01.brs.0000131417.93637.9d"},{"key":"b25","series-title":"Clin Neurol Neurosurg","first-page":"29","article-title":"Adjacent segment disease after instrumented fusion for adult lumbar spondylolisthesis: incidence and risk factors","volume":"156","author":"Zhong ZM","year":"2017","unstructured":"Zhong ZM, Deviren V, Tay B, Burch S, Berven SH. Adjacent segment disease after instrumented fusion for adult lumbar spondylolisthesis: incidence and risk factors. Clin Neurol Neurosurg. 2017;156:29\u201334. doi:10.1016\/j.clineuro.2017.02.020"},{"key":"b26","series-title":"Front Surg","first-page":"1357897","article-title":"Open laminectomy vs. minimally invasive laminectomy for lumbar spinal stenosis: a review","volume":"11","author":"Dhar UK","year":"2024","unstructured":"Dhar UK, Menzer EL, Lin M,  Open laminectomy vs. minimally invasive laminectomy for lumbar spinal stenosis: a review. Front Surg. 2024;11:1357897. doi:10.3389\/fsurg.2024.1357897"},{"issue":"6","key":"b27","series-title":"Neurosurgery","first-page":"1600","article-title":"Adjacent segment degeneration after lumbar interbody fusion with percutaneous pedicle screw fixation for adult low-grade isthmic spondylolisthesis: minimum 3 years of follow-up","volume":"67","author":"Bae JS","year":"2010","unstructured":"Bae JS, Lee SH, Kim JS, Jung B, Choi G. Adjacent segment degeneration after lumbar interbody fusion with percutaneous pedicle screw fixation for adult low-grade isthmic spondylolisthesis: minimum 3 years of follow-up. Neurosurgery. 2010;67(6):1600\u20131608. doi:10.1227\/NEU.0b013e3181f91697"},{"issue":"6","key":"b28","series-title":"Orthopedics","first-page":"546","article-title":"Sagittal alignment as a risk factor for adjacent level degeneration: a case-control study","volume":"31","author":"Djurasovic MO","year":"2008","unstructured":"Djurasovic MO, Carreon LY, Glassman SD, Dimar JR, Puno RM, Johnson JR. Sagittal alignment as a risk factor for adjacent level degeneration: a case-control study. Orthopedics. 2008;31(6):546."},{"issue":"6","key":"b29","series-title":"Eur Spine J","first-page":"1251","article-title":"Pelvic incidence-lumbar lordosis mismatch predisposes to adjacent segment disease after lumbar spinal fusion","volume":"24","author":"Rothenfluh DA","year":"2015","unstructured":"Rothenfluh DA, Mueller DA, Rothenfluh E, Min K. Pelvic incidence-lumbar lordosis mismatch predisposes to adjacent segment disease after lumbar spinal fusion. Eur Spine J. 2015;24(6):1251\u20131258. doi:10.1007\/s00586-014-3454-0"},{"issue":"7","key":"b30","series-title":"Eur Spine J","first-page":"1384","article-title":"Pelvic incidence-lumbar lordosis mismatch results in increased segmental joint loads in the unfused and fused lumbar spine","volume":"23","author":"Senteler M","year":"2014","unstructured":"Senteler M, Weisse B, Snedeker JG, Rothenfluh DA. Pelvic incidence-lumbar lordosis mismatch results in increased segmental joint loads in the unfused and fused lumbar spine. Eur Spine J. 2014;23(7):1384\u20131393. doi:10.1007\/s00586-013-3132-7"},{"issue":"3","key":"b31","series-title":"Neurospine","first-page":"543","article-title":"Lordosis Distribution Index in short-segment lumbar spine fusion - can ideal lordosis reduce revision surgery and iatrogenic deformity?","volume":"18","author":"Bari TJ","year":"2021","unstructured":"Bari TJ, Heegaard M, Bech-Azeddine R, Dahl B, Gehrchen M. Lordosis Distribution Index in short-segment lumbar spine fusion - can ideal lordosis reduce revision surgery and iatrogenic deformity? Neurospine. 2021;18(3):543\u2013553. doi:10.14245\/ns.2040744.372"},{"issue":"3","key":"b32","series-title":"Spine (Phila Pa 1976)","first-page":"303","article-title":"Minimum 5-year analysis of L5-S1 fusion using sacropelvic fixation (bilateral S1 and iliac screws) for spinal deformity","volume":"31","author":"Tsuchiya K","year":"2006","unstructured":"Tsuchiya K, Bridwell KH, Kuklo TR, Lenke LG, Baldus C. Minimum 5-year analysis of L5-S1 fusion using sacropelvic fixation (bilateral S1 and iliac screws) for spinal deformity. Spine (Phila Pa 1976). 2006;31(3):303\u2013308. doi:10.1097\/01.brs.0000197193.81296.f1"},{"issue":"suppl 1","key":"b33","series-title":"Eur Spine J","first-page":"86","article-title":"Revision surgery in distal junctional kyphosis","volume":"29","author":"Berjano P","year":"2020","unstructured":"Berjano P, Damilano M, Pejrona M, Langella F, Lamartina C. Revision surgery in distal junctional kyphosis. Eur Spine J. 2020;29(suppl 1):86-102. doi:10.1007\/s00586-020-06304-y"},{"issue":"5","key":"b34","series-title":"Spine Deform","first-page":"378","article-title":"Lumbosacral junctional failures after long spinal fusion for adult spinal deformity-which vertebra is the preferred distal instrumented vertebra?","volume":"4","author":"Yasuda T","year":"2016","unstructured":"Yasuda T, Hasegawa T, Yamato Y,  Lumbosacral junctional failures after long spinal fusion for adult spinal deformity-which vertebra is the preferred distal instrumented vertebra? Spine Deform. 2016;4(5):378\u2013384. doi:10.1016\/j.jspd.2016.03.001"},{"issue":"17","key":"b35","series-title":"Spine (Phila Pa 1976)","first-page":"E945","article-title":"The comparison of spinopelvic parameters, complications, and clinical outcomes after spinal fusion to S1 with or without additional sacropelvic fixation for adult spinal deformity: a systematic review and meta-analysis","volume":"46","author":"Han B","year":"2021","unstructured":"Han B, Yin P, Hai Y, Cheng Y, Guan L, Liu Y. The comparison of spinopelvic parameters, complications, and clinical outcomes after spinal fusion to S1 with or without additional sacropelvic fixation for adult spinal deformity: a systematic review and meta-analysis. Spine (Phila Pa 1976). 2021;46(17):E945\u2013E953. doi:10.1097\/BRS.0000000000004003"},{"issue":"11","key":"b36","series-title":"Spine (Phila Pa 1976)","first-page":"1192","article-title":"Degeneration of sacroiliac joint after instrumented lumbar or lumbosacral fusion: a prospective cohort study over five-year follow-up","volume":"33","author":"Ha KY","year":"2008","unstructured":"Ha KY, Lee JS, Kim KW. Degeneration of sacroiliac joint after instrumented lumbar or lumbosacral fusion: a prospective cohort study over five-year follow-up. Spine (Phila Pa 1976). 2008;33(11):1192\u20131198. doi:10.1097\/BRS.0b013e318170fd35"},{"issue":"26","key":"b37","series-title":"Spine (Phila Pa 1976)","first-page":"2868","article-title":"Does superior-segment facet violation or laminectomy destabilize the adjacent level in lumbar transpedicular fixation? An in vitro human cadaveric assessment","volume":"33","author":"Cardoso MJ","year":"2008","unstructured":"Cardoso MJ, Dmitriev AE, Helgeson M, Lehman RA, Kuklo TR, Rosner MK. Does superior-segment facet violation or laminectomy destabilize the adjacent level in lumbar transpedicular fixation? An in vitro human cadaveric assessment. Spine (Phila Pa 1976). 2008;33(26):2868\u20132873. doi:10.1097\/BRS.0b013e31818c63d3"},{"issue":"2","key":"b38","series-title":"PLoS One","first-page":"e0171546","article-title":"Minimally invasive procedure reduces adjacent segment degeneration and disease: new benefit-based global meta-analysis","volume":"12","author":"Li XC","year":"2017","unstructured":"Li XC, Huang CM, Zhong CF, Liang RW, Luo SJ. Minimally invasive procedure reduces adjacent segment degeneration and disease: new benefit-based global meta-analysis. PLoS One. 2017;12(2):e0171546. doi:10.1371\/journal.pone.0171546"},{"issue":"14","key":"b39","series-title":"Spine (Phila Pa 1976)","first-page":"1093","article-title":"The difference in superior adjacent segment pathology after lumbar posterolateral fusion by using 2 different pedicle screw insertion techniques in 9-year minimum follow-up","volume":"39","author":"He B","year":"2014","unstructured":"He B, Yan L, Guo H, Liu T, Wang X, Hao D. The difference in superior adjacent segment pathology after lumbar posterolateral fusion by using 2 different pedicle screw insertion techniques in 9-year minimum follow-up. Spine (Phila Pa 1976). 2014;39(14):1093\u20131098. doi:10.1097\/BRS.0000000000000353"},{"issue":"18","key":"b40","series-title":"Spine (Phila Pa 1976)","first-page":"1295","article-title":"Reoperation rates due to adjacent segment disease following primary 1 to 2-level minimally invasive versus open transforaminal lumbar interbody fusion","volume":"48","author":"Galetta MS","year":"2023","unstructured":"Galetta MS, Lorentz NA, Lan R,  Reoperation rates due to adjacent segment disease following primary 1 to 2-level minimally invasive versus open transforaminal lumbar interbody fusion. Spine (Phila Pa 1976). 2023;48(18):1295\u20131299. doi:10.1097\/BRS.0000000000004645"},{"issue":"1","key":"b41","series-title":"Int J Spine Surg","first-page":"74","article-title":"Clinical and radiographic outcomes of lateral interbody fusion for adjacent segment degeneration","volume":"15","author":"Yasmeh S","year":"2021","unstructured":"Yasmeh S, Bernatz J, Garrard E, Bice M, Williams SK. Clinical and radiographic outcomes of lateral interbody fusion for adjacent segment degeneration. Int J Spine Surg. 2021;15(1):74\u201381. doi:10.14444\/8010"},{"issue":"1","key":"b42","series-title":"J Neurosurg Spine","first-page":"21","article-title":"Comparison of anterior- and posterior-approach instrumented lumbar interbody fusion for spondylolisthesis","volume":"7","author":"Min JH","year":"2007","unstructured":"Min JH, Jang JS, Lee SH. Comparison of anterior- and posterior-approach instrumented lumbar interbody fusion for spondylolisthesis. J Neurosurg Spine. 2007;7(1):21\u201326. doi:10.3171\/SPI-07\/07\/021"},{"issue":"25","key":"b43","series-title":"Spine (Phila Pa 1976)","first-page":"2775","article-title":"Preventive effect of artificial ligamentous stabilization on the upper adjacent segment impairment following posterior lumbar interbody fusion","volume":"34","author":"Imagama S","year":"2009","unstructured":"Imagama S, Kawakami N, Matsubara Y, Kanemura T, Tsuji T, Ohara T. Preventive effect of artificial ligamentous stabilization on the upper adjacent segment impairment following posterior lumbar interbody fusion. Spine (Phila Pa 1976). 2009;34(25):2775\u20132781. doi:10.1097\/BRS.0b013e3181b4b1c2"},{"issue":"7","key":"b44","series-title":"Clin Spine Surg","first-page":"260","article-title":"The efficacy of lumbar hybrid fusion for the prevention of adjacent segment disease: fact or artifact? A meta-analysis","volume":"34","author":"Cho HJ","year":"2021","unstructured":"Cho HJ, Ko YS, Won YI,  The efficacy of lumbar hybrid fusion for the prevention of adjacent segment disease: fact or artifact? A meta-analysis. Clin Spine Surg. 2021;34(7):260\u2013268. doi:10.1097\/BSD.0000000000001097"},{"issue":"3","key":"b45","series-title":"Asian Spine J","first-page":"401","article-title":"Dynamic fixation techniques for the prevention of adjacent segment disease: a retrospective controlled study","volume":"16","author":"Fuster S","year":"2022","unstructured":"Fuster S, Mart\u00ednez-Anda JJ, Castillo-Rivera SA, Vargas-Rever\u00f3n C, Tornero E. Dynamic fixation techniques for the prevention of adjacent segment disease: a retrospective controlled study. Asian Spine J. 2022;16(3):401\u2013410. doi:10.31616\/asj.2020.0585"}],"container-title":["Journal of Neurosurgery: Spine"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/44\/5\/article-p693.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-spine\/44\/5\/article-p693.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-spine\/44\/5\/article-p693.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T14:49:28Z","timestamp":1793976568000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/44\/5\/article-p693.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,27]]},"references-count":45,"journal-issue":{"issue":"5"},"URL":"https:\/\/doi.org\/10.3171\/2025.8.spine25770","relation":{},"ISSN":["1547-5654"],"issn-type":[{"value":"1547-5654","type":"print"}],"subject":[],"published":{"date-parts":[[2026,2,27]]}}}