A Commentary on “How to Treat Adjacent-Segment Pathology Following Lumbar Fusion Surgery: Decompression Alone or Decompression With Extended Fusion Surgery?”

Description

Yoon commented in 2026 on a Swedish registry study asking whether worn spinal levels next to a past fusion need decompression alone, or a longer fusion. Surgeons face this choice often, and Yoon notes the clinic saying that no spine operation should be promised as the last. The study drew on Swespine, which captures most Swedish spine surgery.

Among 2,521 patients, repeat surgery was more common after extended fusion at every check. At ten years it reached about a third of that group, against about a quarter after decompression alone. Yoon praises the finding but urges caution: the groups differed from the start, since fusion was chosen for patients with slippage, deformity, or segment pain. Adjustment cannot erase that tilt. For a well-chosen patient, Yoon backs decompression alone as the smaller, safer operation.

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Source: https://europepmc.org/article/MED/PMC13448112