Adjacent level disease can be caused by many things, but I think the one thing the best surgeons will tell you is true is that if the wrong level is selected, leaving the vertebrae below the lowest instrumented vertebrae or the vertebrae above the highest instrumented vertebrae, in a non-horizontal position, leaves the patient more vulnerable to ALD. I think it also can be caused by choosing a top vertebrae that is at a level vulnerable to the forces in the sagittal plane. For example, I think that patients who need to be fused starting at around L1 are usually actually started at T10 or T11 to avoid this problem.
I'm far from being an expert on the subject, and have actually read relatively little of the literature, so as always, I suggest that patients (or parents) follow the advice of qualified professionals.
--Linda
I'm far from being an expert on the subject, and have actually read relatively little of the literature, so as always, I suggest that patients (or parents) follow the advice of qualified professionals.
--Linda
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