Management of Adjacent Segment Degeneration and Spinal Stenosis (Scar)

Adjacent segment degeneration after previous lumbar procedures can lead to recurrent symptoms. While many studies have examined the predisposing factors that may contribute to adjacent segment degeneration, few have outlined the management of this condition once it develops. This article reviews the risk factors and diagnostic workup of lumbar adjacent segment degeneration. Operative considerations for the management of spinal stenosis and epidural scar at the junctional level are highlighted. The limited information on surgical outcomes after reoperation is discussed. Emerging technology may offer novel approaches to managing this condition.

Keywords: spinal stenosis, adjacent segment degeneration, revision laminectomy, junctional stenosis, epidural scar