Adjacent segment pathology (ASP) is thought to occur secondary to the biomechanical effects of fusion or secondary to natural arthritic progression. This systematic review examines ASP in patients with varying degrees of pre-existing spondylosis (degenerative disease, Klippel Feil, trauma, pediatric fusion). In theory, if ASP is secondary to natural arthritic progression and not secondary to the biomechanical effect of fusion, one would observe a lower rate of ASP in populations with a lesser amount of pre-existing spondylosis. This systematic review examines the influence of indication or reason for fusion on ASP.
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