Spine
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Systematic review. ⋯ ASP may occur at a higher rate than natural spinal degeneration and suggests that another factor (such as biomechanical effect of fusion) may accelerate pathologic changes. Strength of Statement: Weak.
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Systematic review. ⋯ No recommendations regarding the use of current classification of degeneration at any segments can be made based on the available literature. A new comprehensive definition for adjacent segment pathology (ASP, the now preferred terminology) has been proposed in this Focus Issue, which reflects the diverse pathology observed at functional spinal units adjacent to previous spinal reconstruction and balances detailed stratification with clinical utility. A comprehensive classification system is being developed through expert opinion and will require validation as well as peer review. Strength of Statement: Strong.
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Systematic review. ⋯ 1. The risk of developing new symptoms secondary to distal adjacent segment pathology following long thoracolumbar fusion for deformity is approximately 18–20% during a period of 9 years follow up, and most of these patients will require revision surgery. Strength of Statement: Weak. 2. The risk of developing distal adjacent segment pathology may be higher in those with preoperative sagittal imbalance, preoperative disc degeneration, longer fusions, circumferential procedures, and postoperative L5–S1 disc space narrowing. Strength of Statement: Weak.
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A population-based magnetic resonance imaging (MRI) study of the cervical spine. ⋯ In this MRI study, the prevalence of CCC was examined. The present results indicate that CCC correlates with physical performance measures from an early stage of the disease before myelopathic signs appear.
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Systematic review. ⋯ Insufficient. Strength of Statement: Strong.