[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"health-studies-list:{\"conditionNormalized\":\"adjacent-segment-disease\",\"overallStatus\":[\"RECRUITING\",\"AVAILABLE\",\"NOT_YET_RECRUITING\"],\"orderBy\":\"LastUpdateSubmitDate:desc\",\"size\":25,\"offset\":0}":3,"health-study-condition:adjacent-segment-disease":26},{"pageToken":4,"total":5,"offset":6,"count":5,"results":7},null,2,0,[8,43],{"id":9,"slug":10,"hasResults":11,"nctId":12,"briefTitle":13,"officialTitle":13,"acronym":14,"eligibilityCriteria":15,"healthyVolunteers":11,"sex":16,"minAge":17,"maxAge":4,"enrollmentInfo":18,"targetDuration":4,"studyType":21,"phases":22,"briefSummary":24,"conditions":25,"keywords":28,"overallStatus":30,"whyStopped":4,"lastUpdateSubmitDate":31,"lastUpdatePostDateStruct":32,"startDateStruct":35,"completionDateStruct":37,"leadSponsor":39,"locationsCount":42},"100642599","surgical-treatment-of-adjacent-segment-stenosis-100642599",false,"NCT07661199","Surgical Treatment of Adjacent Segment Stenosis","STASS","Inclusion Criteria:\n\n* Age ≥18 years.\n* Oswestry Disability Index (ODI) between 30% and 80% at screening.\n* Symptomatic adjacent segment stenosis following degenerative lumbar fusion surgery.\n* Persistent symptoms despite at least 6 weeks of appropriate conservative treatment.\n* Radiological evidence of adjacent segment spinal stenosis on magnetic resonance imaging (MRI).\n* Ability to understand the study procedures and complete patient-reported outcome questionnaires.\n* Ability to provide written informed consent.\n\nExclusion Criteria:\n\n* Adjacent segment kyphosis or scoliosis greater than 10 degrees.\n* Screw loosening or pseudarthrosis of the previous fusion construct.\n* Known current pregnancy or breastfeeding.\n* Acute traumatic spinal injury or fracture.\n* Active inflammatory disease of the spine.\n* Active neoplastic disease of the spine.\n* Contraindication to spinal surgery.\n* Inability to provide informed consent or complete study questionnaires.\n* Symptoms attributable to spinal stenosis are not the predominant clinical complaint\n* Foraminal stenosis grade ≥2 according to the Lee classification.\n* Dynamic spondylolisthesis ≥3 mm on flexion-extension radiographs.\n* Persons involuntarily detained by judicial or administrative order.","ALL","18 Years",{"count":19,"type":20},338,"ESTIMATED","INTERVENTIONAL",[23],"NA","The goal of this clinical trial is to learn whether microdecompression alone is as effective as decompression with extension of fusion surgery in patients with symptomatic adjacent segment stenosis after previous lumbar fusion surgery.\n\nThe main questions it aims to answer are:\n\nIs microdecompression alone non-inferior to decompression with extension of fusion in improving disability 24 months after surgery, as measured by the Oswestry Disability Index (ODI)? Does microdecompression alone result in similar or lower rates of complications, reoperations, pain, and radiological progression compared with decompression and fusion?\n\nResearchers will compare microdecompression alone to decompression with extension of lumbar fusion to determine whether the less invasive procedure can achieve similar clinical outcomes while reducing surgical burden and preserving spinal structures.\n\nParticipants will:\n\nBe randomly assigned to one of two treatment groups: microdecompression alone or decompression with extension of lumbar fusion.\n\nUndergo the assigned surgical treatment. Attend clinical and radiological follow-up visits at 6, 12, and 24 months after surgery.\n\nComplete questionnaires assessing disability, pain, quality of life, sleep quality, and mental health.\n\nUndergo routine imaging and clinical examinations to evaluate treatment outcomes and possible complications.",[26,27],"Adjacent Segment Disease","Lumbar Spinal Stenosis",[26,29,27],"Adjacent Segment Stenosis","NOT_YET_RECRUITING","2026-06-18",{"date":33,"type":34},"2026-06-22","ACTUAL",{"date":36,"type":20},"2026-10-01",{"date":38,"type":20},"2031-03-01",{"name":40,"class":41},"Charite University, Berlin, Germany","OTHER",1,{"id":44,"slug":45,"hasResults":11,"nctId":46,"briefTitle":47,"officialTitle":48,"acronym":4,"eligibilityCriteria":49,"healthyVolunteers":50,"sex":16,"minAge":17,"maxAge":4,"enrollmentInfo":51,"targetDuration":4,"studyType":53,"phases":4,"briefSummary":54,"conditions":55,"keywords":4,"overallStatus":56,"whyStopped":4,"lastUpdateSubmitDate":57,"lastUpdatePostDateStruct":58,"startDateStruct":60,"completionDateStruct":62,"leadSponsor":64,"locationsCount":42},"100404160","decompression-versus-decompression-and-fusion-100404160","NCT04542720","Decompression Versus Decompression and Fusion","Decompression Versus Decompression and Fusion for Lumbar Adjacent Segment Disease","Inclusion Criteria:\n\n* Adult patients at least one year removed from a previous instrumented posterior lumbar fusion\n* Patients with any prior posterior fusion involving L2 to the sacrum, whether single-level or multilevel\n* Patients with symptoms related to central and lateral recess at the supradjacent level that have persisted despite at least six weeks of non-operative therapy modalities\n\nExclusion Criteria:\n\n* Patients with previous uninstrumented lumbar fusions\n* Patients with traumatic, neoplastic, or infectious etiologies at the adjacent segment\n* Patients with prior iliac or sacroiliac fixation and those with nonunion as the primary indication for surgery\n* Patients with pre-existing instability at the supradjacent level. The definition of instability will be determined based on standing lateral, flexion and extension plain radiographs. Patients with \\>3mm of change between these views will be excluded.\n* Retrolisthesis will not be a criterion for exclusion",true,{"count":52,"type":20},96,"OBSERVATIONAL","Adjacent segment disease (ASD) in the lumbar spine is a well-known sequela of lumbar fusion surgery. The annual incidence of adjacent level re-operation is approximately 3% with a ten-year prevalence of 20-30%. Frequently, the surgical treatment involves decompression of the adjacent level coupled with extension of the instrumentation and fusion. Advocates of this paradigm cite the altered kinematics and biomechanics of levels adjacent to a lumbar fusion mass. Furthermore, decompressed levels adjacent to a fused segments are associated with higher rates of ASD in retrospective studies. Yet, a retrospective review of higher quality data concluded decompression adjacent to single-level fusion provides similar outcomes compared to fusions extending across the decompressed segments.\n\nGiven the conflicting data currently available, higher quality data are needed to guide surgical decision-making in ASD. The purpose of this trial is to prospectively compare decompression and decompression with fusion in patients with lumbar ASD.",[26],"RECRUITING","2025-11-18",{"date":59,"type":34},"2025-11-21",{"date":61,"type":34},"2020-09-01",{"date":63,"type":20},"2027-09",{"name":65,"class":41},"Massachusetts General Hospital"]