Project Details
Projekt
Surgical Treatment of Adjacent Segment Stenosis
Applicant
Privatdozent Dr. Anton Früh
Subject Area
Clinical Neurology; Neurosurgery and Neuroradiology
Term
since 2026
Project identifier
Deutsche Forschungsgemeinschaft (DFG) - Project number 574896382
Surgeries on the lumbar spine are among the most frequently performed surgical procedures in Germany. In particular, the number of spinal fusions is increasing. Compared to minimally invasive procedures, these surgeries result in higher blood loss, longer hospitalization and increased morbidity. Additionally, spinal fusion surgeries significantly alter the biomechanics of the spine column. The loss of muscle and iatrogenic scarring can weaken the spinal bracing, potentially leading to a serious late consequence known as adjacent segment disease. This condition involves the degeneration of intervertebral discs, hypertrophy of facet joints, hypertrophy of ligaments, and ultimately nerve compression due to spinal canal stenosis. Unfortunately, according to current scientific knowledge, non-surgical treatment of spinal stenosis and the resulting pain symptoms is rarely successful, making surgical intervention necessary in most cases. Typically, according to current scientific understanding, if adjacent segment degeneration occurs after a stabilizing operation, the adjacent segment is decompressed and the fusion is extended. However, the authors demonstrated in a pilot study that purely microsurgical decompression without fusion of the adjacent level can also lead to favorable clinical results. There was no increase in the number of revision procedures needed to stabilize the potentially unstable segment. However, this minimal invasive treatment option has not yet been investigated in a prospective study. With this proposal, the applicants aim to conduct a prospective randomized controlled study to investigate whether a purely microsurgical decompression of the adjacent segment is not inferior to decompression with extension of the fusion. This study could generate data that would establish microsurgical treatment as the gold standard for treating adjacent segment stenosis. Thus, invasive spinal fusions with high complication rates and a higher risk for subsequent spine surgeries could be avoided in many patients. In addition to relieving patients, this could also lead to cost reductions in the healthcare system.
DFG Programme
Clinical Trials
