Adjacent Segment Pathology is defined as degeneration at a spinal level adjacent to fusion. In the cervical spine the rate is reported to be around 3% a year and at 10 years 25% report symptoms of adjacent segment disease. It is unresolved if it is a natural progression of an inherent predisposition for degenerative disease or altered biomechanics as a consequence of fusion. In a large multicentre study (Spine Patient Outcome Research Trial or SPORT), it was shown that the only specific risk for reapportion was a duration of symptoms greater that 12 months.


Is is a condition which is characterised by the development of radiological or clinically evident symptoms at a spinal level, which is contiguous to a previously operated level

Clinical Presentation

Patients typically present with extremity (including buttock) pain and heaviness associated with walking. This pain may improve with rest and flexion of the spine (bending forward)

Radiographic Presentation

Xrays usually reveal degenerative changes and sometimes a full length spinal x-ray will be requested to access for overall alignment. MRI scanning will corroborate the diagnosis and provide a guide to treatment.