I had a spinal fusion some years ago. I hear that people like me can develop a problem called transitional syndrome after fusion. What is that?

There is a concern that the motion segment above and below the fusion site can start to break down. This may appear on X-rays as increased degeneration called accelerated segment degeneration (ASD).

The patients start to have new symptoms at the level above the fusion. This occurs after a quiet period without symptoms after spinal fusion. The new symptoms may signal a transition from a normal to abnormal motion segment. Transitional syndrome doesn't usually happen right away. The average period of time reported is between three and 13 years after the first fusion.

Patients with more than one level fused are more likely to develop transitional syndrome. Factors that put you at increased risk for transitional syndrome include osteopororis (brittle bones), fusions at more than two levels, and generalized (usually age-related) disc disease.