Clinical and radiographic outcomes of adjacent segment degeneration after short-segment fixation for lumbar vertebral fracture

Objectives: This study aimed to examine the incidence and clinical implications of adjacent segment degeneration (ASD) following short-segment fixation for traumatic lumbar fractures and to compare the findings with the existing literature on degenerative spinal disease. Methods: This retrospective study included a cohort of 55 patients who underwent short-segment fixation for lumbar vertebral fractures. Radiographic ASD was evaluated using imaging modalities focusing on disc area reduction and facet joint degeneration. Clinical outcomes were quantified using the Visual Analog Scale (VAS) and Oswestry Disability Index (ODI) scores, with a mean follow-up duration of 14.02 months. Statistical analyses were conducted to compare outcomes between patients with and without ASD. Results: Radiographic ASD was observed in 36.4% of the patients. No statistically significant differences in the VAS or ODI scores were identified between the ASD and non-ASD groups throughout the follow-up period. The degenerative changes observed included a decreased disc area and erosion of the facet joints, which are consistent with the increased biomechanical stress experienced post-fusion. Importantly, degeneration of the distal segments was more prevalent in patients with traumatic injuries than in those with proximal segment degeneration, which is typically reported in cohorts with degenerative diseases. Conclusions: The mismatch between structural changes and symptoms indicates that ASD pathophysiology may vary between traumatic and degenerative conditions. Future research should involve larger samples and longer follow-up periods to better understand the long-term clinical effects.