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When patients compare spine surgery options, one term comes up again and again: adjacent segment disease. At Minimally Invasive Neurosurgery of Texas, Dr. Scott Kutz, MD, a neurosurgeon board-certified by the American Board of Neurological Surgery (ABNS) serving patients in Lewisville, TX and Plano, TX, often explains this concept to patients researching artificial disc replacement Lewisville TX options and comparing artificial disc replacement vs fusion.

This article answers a practical question: what is adjacent segment disease, why does spinal motion matter after surgery, and what does the research actually show? You will also learn about the limits of that research, the risks of surgery, and the alternatives to consider.

If you are weighing surgical options and want to understand how they may affect your spine over time, contact Minimally Invasive Neurosurgery of Texas to discuss an evaluation.

Key Takeaways

• Adjacent segment disease refers to symptomatic wear at the spinal levels above or below a previously treated level.
• When one level stops moving after fusion, nearby levels may take on more stress over time.
• Natural aging also causes disc changes, so not every case is caused by an earlier surgery.
• Several long-term cervical studies report lower adjacent-level surgery rates after disc replacement, though results vary between trials.
• Disc replacement is not right for everyone, and fusion remains an appropriate choice for many patients.

Table of Contents

• What Is Adjacent Segment Disease?
• Why Does Adjacent Segment Disease Happen?
• What Research Shows About Disc Replacement and Adjacent Levels
• Artificial Disc Replacement Lewisville TX and Plano TX: Is Motion Preservation an Option for You?
• Risks and Alternatives to Consider
• Minimally Invasive Neurosurgery of Texas: Motion-Preserving Evaluations
• Take the Next Step With a Clearer Plan
• Frequently Asked Questions

What Is Adjacent Segment Disease?

Your spine is made of many moving segments. Each segment includes two vertebrae and the disc between them. When one segment is treated surgically, the segments directly above and below it are called adjacent segments.

Degeneration vs Disease

Specialists distinguish between two related terms. Adjacent segment degeneration describes changes that appear on imaging at the neighboring levels. Adjacent segment disease describes those changes when they cause symptoms, such as pain, numbness, or weakness, that may require treatment.

Where It Occurs

Adjacent segment disease can occur in both the neck and the lower back. It is discussed most often after fusion procedures, because fusion changes how motion is shared across the spine.

Why Does Adjacent Segment Disease Happen?

Load Sharing Across the Spine

Each spinal level contributes a small share of your overall motion. After a fusion heals, the treated level no longer bends or rotates. The levels above and below compensate by moving a bit more, and that extra motion may increase stress on their discs and joints over time.

Natural Aging Also Plays a Role

Discs change with age whether or not you have had surgery. Some patients develop changes at neighboring levels simply because those discs were already beginning to degenerate. For this reason, it is not always possible to know whether an adjacent problem was caused by an earlier surgery, by aging, or by both.

Why Motion Preservation Became a Goal

The possibility of extra stress on nearby levels is one of the main reasons artificial disc replacement was developed. By using an implant designed to allow controlled motion, disc replacement aims to keep load sharing closer to normal. This is the core idea behind motion-preserving spine surgery, and why patients researching motion-preserving spine surgery Plano TX options often ask about adjacent levels.

What Research Shows About Disc Replacement and Adjacent Levels

Long-term data on this question comes mainly from cervical studies.

Findings From Long-Term Trials

In a 10-year randomized clinical trial available through the National Library of Medicine’s PubMed Central, progression to radiographically significant adjacent-segment changes was observed in 12.9% of cervical disc arthroplasty patients compared with 39.3% of fusion patients. The risk of adjacent-level surgery in that trial was 3.1% compared with 20.5%.

Why the Findings Vary

Not every trial has shown the same size of difference. A separate 10-year trial of the BRYAN cervical disc, published in the journal Neurosurgery, reported adjacent-level reoperation rates of 9.7% after disc replacement and 15.8% after fusion, a difference that did not reach statistical significance. Differences in implants, patient selection, and study design can all influence results.

What This Means for Patients

The research suggests that disc replacement may lower the chance of adjacent-level problems for some carefully selected patients. It does not mean fusion is a poor choice, and it does not predict what will happen in any individual case.

Artificial Disc Replacement Lewisville TX and Plano TX: Is Motion Preservation an Option for You?

Factors a Specialist Reviews

Motion preservation is only helpful if your spine can support it. A specialist may consider disc replacement when:

• The problem involves one or two levels
• Bone quality is good
• The facet joints at that level are healthy
• There is no instability or deformity
• Symptoms have not improved with conservative care

Next Steps for Your Evaluation

For patients exploring degenerative disc disease treatment Lewisville TX options, a review of your imaging can show whether these conditions apply. Patients who have already had a fusion and now have symptoms at a neighboring level may also benefit from a revision spine surgery evaluation.

Risks and Alternatives to Consider

Risks of Disc Replacement

General risks include infection, bleeding, nerve irritation, temporary hoarseness or difficulty swallowing after neck procedures, implant wear, movement or settling, bone forming around the implant that can limit its motion, and the possibility of further treatment later. Like any surgery, disc replacement is a decision to weigh carefully with your surgeon.

Fusion Remains an Appropriate Option

Fusion is well established and may provide a more predictable result for patients with instability, advanced facet arthritis, osteoporosis, deformity, or multi-level disease.

Non-Surgical Alternatives

Many patients improve with physical therapy, medication, epidural steroid injections, and activity changes. Surgery is usually discussed when symptoms persist despite these treatments or when nerve symptoms are significant.

Minimally Invasive Neurosurgery of Texas: Motion-Preserving Evaluations

Dr. Scott C. Kutz, MD is a neurosurgeon and spine surgeon, board-certified by the American Board of Neurological Surgery (ABNS), with more than 25 years of experience and more than 6,000 patients treated. He is the founder and head neurosurgeon of Minimally Invasive Neurosurgery of Texas, a private practice in Lewisville, TX and Plano, TX dedicated exclusively to minimally invasive and motion-preserving surgical techniques for spinal conditions. He has been a Fellow of the American Association of Neurological Surgeons (AANS) since 2011 and the American College of Surgeons (ACS) since 2010.

Dr. Kutz specializes in endoscopic spine surgery, artificial disc replacement, sacroiliac joint fusion, and complex revision spine surgery. His approach prioritizes the least invasive appropriate option first, using advanced surgical techniques designed to minimize tissue disruption, with the goal of long-term symptom improvement for patients across the Dallas-Fort Worth area and beyond. He evaluates patients for both motion-preserving and fusion-based procedures so each recommendation is matched to the patient’s anatomy.

To review your options with Dr. Scott Kutz, MD, contact Minimally Invasive Neurosurgery of Texas.

Take the Next Step With a Clearer Plan

Understanding adjacent segment disease can help you ask better questions about any spine surgery recommendation. If you are researching artificial disc replacement Lewisville TX options, an evaluation can show whether your spine may support a motion-preserving approach and how each option could affect neighboring levels.

Patients from Lewisville, Plano, Frisco, Denton, and across the Dallas-Fort Worth area can learn more about artificial disc replacement at Minimally Invasive Neurosurgery of Texas before their appointment.

To discuss how a surgical option may affect your spine over time, contact Minimally Invasive Neurosurgery of Texas to schedule an evaluation.

Frequently Asked Questions

What is adjacent segment disease?

Adjacent segment disease is symptomatic wear at the spinal levels directly above or below a previously treated level. It can cause pain, numbness, or weakness and may require treatment. It is discussed most often after fusion, though natural aging also contributes, so not every case is caused by the earlier surgery.

Does every fusion lead to adjacent segment disease?

No. Many fusion patients never develop symptoms at neighboring levels. Fusion can add stress to nearby discs, and some patients do develop adjacent problems over the years, but the likelihood depends on factors such as age, existing degeneration, and the number of levels treated. Your surgeon can discuss your individual risk.

Can artificial disc replacement prevent adjacent segment disease?

No procedure can promise that. Several long-term cervical studies report lower adjacent-level surgery rates after disc replacement compared with fusion, but results vary between trials. Disc replacement may reduce the chance for some carefully selected patients, and a specialist can explain whether you are a candidate.

What are the symptoms of adjacent segment disease?

Symptoms can resemble the original problem: neck or back pain, stiffness, or pain, numbness, tingling, or weakness traveling into the arms or legs. Because symptoms overlap with many other conditions, anyone with new or returning symptoms after spine surgery should see a qualified specialist for an evaluation.

How is adjacent segment disease treated?

Treatment often starts with physical therapy, medication, and injections. When symptoms persist, options may include decompression, extending a fusion, or in selected cases disc replacement at the neighboring level. The right approach depends on imaging, the prior surgery, and overall health, so a careful revision evaluation is important.

What are the risks of surgery for adjacent segment disease?

Surgery near a previous operation can be more complex because of scar tissue and existing hardware. General risks include infection, bleeding, nerve irritation, and the possibility of further treatment. An experienced surgeon reviews prior operative reports and current imaging to plan carefully and explain the risks that apply to you.

Medical Disclaimer: This article is for educational purposes only and is not medical advice. Individual results vary. Please consult a qualified physician about your specific condition. To discuss your options with Dr. Scott Kutz, MD, contact Minimally Invasive Neurosurgery of Texas.