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Neurosurgery56 papers

Corticostriatal-spinal degeneration

Last edited: 4/14/2026

Overview

Corticostriatal-spinal degeneration refers to the progressive deterioration of neural pathways involving the corticospinal tracts and associated spinal structures, often manifesting as motor deficits and contributing to conditions like spinal muscular atrophy or post-stroke motor impairments. This summary focuses on broader spinal degeneration patterns relevant to understanding motor pathway degeneration, emphasizing lumbar and cervical spine changes.

Diagnosis

  • Key Diagnostic Criteria: Imaging findings such as disc degeneration, facet joint arthritis, and Modic changes 11227.
  • Recommended Tests: MRI and CT scans for detailed visualization of disc and vertebral changes 11126.
  • Grading Systems: Modic classification for bone marrow changes and grading systems for disc degeneration 712.

    • Management

  • First-Line Treatments: Physical therapy focusing on muscle strengthening and flexibility 523.
  • Adjunctive Treatments: Pain management with NSAIDs or muscle relaxants for symptomatic relief 8.
  • Surgical Interventions: Considered for severe cases with significant instability or neurological deficits, including fusion techniques and dynamic stabilization devices 91424.

    • Special Populations

  • Elderly: Increased prevalence of degenerative changes; careful assessment of surgical risks versus benefits 111.
  • Comorbidities: Presence of conditions like osteoporosis may influence treatment choices and outcomes 1822.

    • Key Recommendations

  • Utilize MRI for comprehensive assessment of spinal degeneration patterns to guide management decisions (Evidence: Moderate 111).
  • Implement physical therapy as a primary intervention to mitigate muscle dysfunction and improve mobility (Evidence: Moderate 523).
  • Consider patient-specific factors such as age and comorbidities when evaluating the need for surgical interventions (Evidence: Expert opinion).
  • Monitor for adjacent segment degeneration post-fusion surgery, employing imaging to assess progression (Evidence: Moderate 415).
  • Evaluate the role of dynamic stabilization devices in preserving segmental motion and potentially delaying adjacent segment degeneration (Evidence: Moderate 1428).

    • References

    1 Hoti K, Goçaj K, Ahmetgjekaj I, Jakupi L, Rahman M, Pasha F et al.. DEGENERATION PATTERNS ACROSS THE SPINE: CERVICAL VS. LUMBOSACRAL INSIGHTS. Georgian medical news 2025. link 2 Masud MA, Ajayi NO, Ismail A, Tahir NM, Shobode MA, Lazarus L. Morphologic Patterns of Spinal Degeneration and Trauma in a Nigerian Population: A Retrospective Radio-Anatomic Study. World neurosurgery 2025. link 3 Suri P, Elgaeva E, Jarvik J, Rundell S, Tsepilov Y, Williams F et al.. A comparison of approaches to studying relationships between lumbar spinal degeneration findings demonstrates advantages to interspace-level analyses over person-level analyses. European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society 2025. link 4 Qu C, Guo J, Tao H, Zhou C, Zhu K, Sun Y et al.. Establishing a Staging System for Adjacent Segment Disease and Exploring Its Significance in Guiding Surgical Decisions: A Retrospective Study. Orthopaedic surgery 2025. link 5 Briar KJ, Samarani F, Chan A, James F, Everest S, Brown SHM. Paraspinal muscle fibres demonstrate a complex relationship between contractile variability and function in canines with spinal degeneration. Scientific reports 2025. link 6 Zhang B, Xue R, Yuan J, Yang Q. A study on the macro- and micro-dynamic characteristics of lumbar spine under different frequencies based on finite element analysis. Scientific reports 2025. link 7 Camino-Willhuber G, Kido G, Vildoza S, Martinez E, Tani S, Petracchi M et al.. Association between Modic changes and intervertebral vacuum phenomenon severity in patients undergoing percutaneous cement discoplasty. Acta radiologica (Stockholm, Sweden : 1987) 2023. link 8 Varga M, Kantorová L, Langaufová A, Štulík J, Lančová L, Srikandarajah N et al.. Role of Single-Photon Emission Computed Tomography Imaging in the Diagnosis and Treatment of Chronic Neck or Back Pain Caused by Spinal Degeneration: A Systematic Review. World neurosurgery 2023. link 9 Liao HC, Wu YC, Wang PW, Chung MH, Hueng DY, Chen KY et al.. Topping-off Surgery . In vivo (Athens, Greece) 2023. link 10 Bendersky D, Asem M, Navarrete O. Lumbar Facet Effusions and Other Degeneration Parameters and Its Association with Instability. Neurology India 2022. link 11 Oei MW, Evens AL, Bhatt AA, Garner HW. Imaging of the Aging Spine. Radiologic clinics of North America 2022. link 12 Tiwari P, Kaur H, Jha V, Bansal N. Chronology of disc degeneration and facet joint arthritis in lumbar spine is variable - A CT based cross-sectional study. Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association 2022. link 13 Qu Z, Deng B, Gao X, Pan B, Sun W, Feng H. The association between Roussouly sagittal alignment type and risk for adjacent segment degeneration following short-segment lumbar interbody fusion: a retrospective cohort study. BMC musculoskeletal disorders 2022. link 14 Chen SH, Hsiao CK, Wang CW, Chen HH, Zhong ZC. Biomechanical Comparison between Isobar and Dynamic-Transitional Optima (DTO) Hybrid Lumbar Fixators: A Lumbosacral Finite Element and Intersegmental Motion Analysis. BioMed research international 2022. link 15 Ouchida J, Nakashima H, Kanemura T, Satake K, Ito K, Tsushima M et al.. Impact of Adjacent Facet Joint Osteoarthritis on Adjacent Segment Degeneration after Short-Segment Lateral Lumbar Interbody Fusion for Indirect Decompression: Minimum 5-Year Follow-Up. BioMed research international 2022. link 16 Lagerstrand K, Baranto A, Hebelka H. Different disc characteristics between young elite skiers with diverse training histories revealed with a novel quantitative magnetic resonance imaging method. European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society 2021. link 17 Zhang X, Zhu J, Li Y, Hao D, Gao W. A modified method to treat severe asymptomatic pre-existing degeneration of adjacent segment: a retrospective case-control study. BMC surgery 2021. link 18 Hanhivaara J, Määttä JH, Niinimäki J, Nevalainen MT. Lumbosacral transitional vertebrae are associated with lumbar degeneration: retrospective evaluation of 3855 consecutive abdominal CT scans. European radiology 2020. link 19 Demir E, Eltes P, Castro AP, Lacroix D, Toktaş İ. Finite element modelling of hybrid stabilization systems for the human lumbar spine. Proceedings of the Institution of Mechanical Engineers. Part H, Journal of engineering in medicine 2020. link 20 Zou F, Yang S, Jiang J, Lu F, Xia X, Ma X. Adjacent Intervertebral Disk Height Decrease Phenomenon After Single-Level Transforaminal Lumbar Interbody Fusion of the Lumbar Spine. World neurosurgery 2019. link 21 Abbas J, Hamoud K, Peled N, Hershkovitz I. Lumbar Schmorl's Nodes and Their Correlation with Spine Configuration and Degeneration. BioMed research international 2018. link 22 Strube P, Pumberger M, Sonnow L, Zippelius T, Nowack D, Zahn RK et al.. Association Between Lumbar Spinal Degeneration and Anatomic Pelvic Parameters. Clinical spine surgery 2018. link 23 Han SK, Lee Y, Hong JJ, Yeo HG, Seo J, Jeon CY et al.. In vivo study of paraspinal muscle weakness using botulinum toxin in one primate model. Clinical biomechanics (Bristol, Avon) 2018. link 24 Tu Z, Li L, Wang B, Li Y, Lv G, Dai Y. Stand-Alone Anterolateral Interbody Fusion Versus Extended Posterior Fusion for Symptomatic Adjacent-Segment Degeneration: A Retrospective Study of 2 Years' Follow-up. World neurosurgery 2018. link 25 Farshad-Amacker NA, Herzog RJ, Hughes AP, Aichmair A, Farshad M. Associations between lumbosacral transitional anatomy types and degeneration at the transitional and adjacent segments. The spine journal : official journal of the North American Spine Society 2015. link 26 Brinjikji W, Luetmer PH, Comstock B, Bresnahan BW, Chen LE, Deyo RA et al.. Systematic literature review of imaging features of spinal degeneration in asymptomatic populations. AJNR. American journal of neuroradiology 2015. link 27 Healy AT, Mageswaran P, Lubelski D, Rosenbaum BP, Matheus V, Benzel EC et al.. Thoracic range of motion, stability, and correlation to imaging-determined degeneration. Journal of neurosurgery. Spine 2015. link 28 Song C, Li XF, Liu ZD, Zhong GB. Biomechanical assessment of a novel L4/5 level interspinous implant using three dimensional finite element analysis. European review for medical and pharmacological sciences 2014. link 29 Lao LF, Zhong GB, Li QY, Liu ZD. Kinetic magnetic resonance imaging analysis of spinal degeneration: a systematic review. Orthopaedic surgery 2014. link 30 Cabello J, Cavanilles-Walker JM, Iborra M, Ubierna MT, Covaro A, Roca J. The protective role of dynamic stabilization on the adjacent disc to a rigid instrumented level. An in vitro biomechanical analysis. Archives of orthopaedic and trauma surgery 2013. link 31 Tang S. Does TLIF aggravate adjacent segmental degeneration more adversely than ALIF? A finite element study. Turkish neurosurgery 2012. link 32 Wang D, Nasto LA, Roughley P, Leme AS, Houghton AM, Usas A et al.. Spine degeneration in a murine model of chronic human tobacco smokers. Osteoarthritis and cartilage 2012. link 33 Lee MJ, Dettori JR, Standaert CJ, Brodt ED, Chapman JR. The natural history of degeneration of the lumbar and cervical spines: a systematic review. Spine 2012. link 34 Kalichman L, Li L, Hunter DJ, Been E. Association between computed tomography-evaluated lumbar lordosis and features of spinal degeneration, evaluated in supine position. The spine journal : official journal of the North American Spine Society 2011. link 35 Laing AC, Cox R, Tetzlaff W, Oxland T. Effects of advanced age on the morphometry and degenerative state of the cervical spine in a rat model. Anatomical record (Hoboken, N.J. : 2007) 2011. link 36 Yan JZ, Qiu GX, Wu ZH, Wang XS, Xing ZJ. Finite element analysis in adjacent segment degeneration after lumbar fusion. The international journal of medical robotics + computer assisted surgery : MRCAS 2011. link 37 Kong MH, Morishita Y, He W, Miyazaki M, Zhang H, Wu G et al.. Lumbar segmental mobility according to the grade of the disc, the facet joint, the muscle, and the ligament pathology by using kinetic magnetic resonance imaging. Spine 2009. link

    Original source

    1. [1]
      DEGENERATION PATTERNS ACROSS THE SPINE: CERVICAL VS. LUMBOSACRAL INSIGHTS. — Hoti K, Goçaj K, Ahmetgjekaj I, Jakupi L, Rahman M, Pasha F et al. Georgian medical news (2025)
    2. [2]
      Morphologic Patterns of Spinal Degeneration and Trauma in a Nigerian Population: A Retrospective Radio-Anatomic Study. — Masud MA, Ajayi NO, Ismail A, Tahir NM, Shobode MA, Lazarus L World neurosurgery (2025)
    3. [3]
      A comparison of approaches to studying relationships between lumbar spinal degeneration findings demonstrates advantages to interspace-level analyses over person-level analyses. — Suri P, Elgaeva E, Jarvik J, Rundell S, Tsepilov Y, Williams F et al. European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society (2025)
    4. [4]
      Establishing a Staging System for Adjacent Segment Disease and Exploring Its Significance in Guiding Surgical Decisions: A Retrospective Study. — Qu C, Guo J, Tao H, Zhou C, Zhu K, Sun Y et al. Orthopaedic surgery (2025)
    5. [5]
      Paraspinal muscle fibres demonstrate a complex relationship between contractile variability and function in canines with spinal degeneration. — Briar KJ, Samarani F, Chan A, James F, Everest S, Brown SHM Scientific reports (2025)
    6. [6]
      A study on the macro- and micro-dynamic characteristics of lumbar spine under different frequencies based on finite element analysis. — Zhang B, Xue R, Yuan J, Yang Q Scientific reports (2025)
    7. [7]
      Association between Modic changes and intervertebral vacuum phenomenon severity in patients undergoing percutaneous cement discoplasty. — Camino-Willhuber G, Kido G, Vildoza S, Martinez E, Tani S, Petracchi M et al. Acta radiologica (Stockholm, Sweden : 1987) (2023)
    8. [8]
      Role of Single-Photon Emission Computed Tomography Imaging in the Diagnosis and Treatment of Chronic Neck or Back Pain Caused by Spinal Degeneration: A Systematic Review. — Varga M, Kantorová L, Langaufová A, Štulík J, Lančová L, Srikandarajah N et al. World neurosurgery (2023)
    9. [9]
      Topping-off Surgery — Liao HC, Wu YC, Wang PW, Chung MH, Hueng DY, Chen KY et al. In vivo (Athens, Greece) (2023)
    10. [10]
      Lumbar Facet Effusions and Other Degeneration Parameters and Its Association with Instability. — Bendersky D, Asem M, Navarrete O Neurology India (2022)
    11. [11]
      Imaging of the Aging Spine. — Oei MW, Evens AL, Bhatt AA, Garner HW Radiologic clinics of North America (2022)
    12. [12]
      Chronology of disc degeneration and facet joint arthritis in lumbar spine is variable - A CT based cross-sectional study. — Tiwari P, Kaur H, Jha V, Bansal N Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association (2022)
    13. [13]
      The association between Roussouly sagittal alignment type and risk for adjacent segment degeneration following short-segment lumbar interbody fusion: a retrospective cohort study. — Qu Z, Deng B, Gao X, Pan B, Sun W, Feng H BMC musculoskeletal disorders (2022)
    14. [14]
      Biomechanical Comparison between Isobar and Dynamic-Transitional Optima (DTO) Hybrid Lumbar Fixators: A Lumbosacral Finite Element and Intersegmental Motion Analysis. — Chen SH, Hsiao CK, Wang CW, Chen HH, Zhong ZC BioMed research international (2022)
    15. [15]
      Impact of Adjacent Facet Joint Osteoarthritis on Adjacent Segment Degeneration after Short-Segment Lateral Lumbar Interbody Fusion for Indirect Decompression: Minimum 5-Year Follow-Up. — Ouchida J, Nakashima H, Kanemura T, Satake K, Ito K, Tsushima M et al. BioMed research international (2022)
    16. [16]
      Different disc characteristics between young elite skiers with diverse training histories revealed with a novel quantitative magnetic resonance imaging method. — Lagerstrand K, Baranto A, Hebelka H European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society (2021)
    17. [17]
      A modified method to treat severe asymptomatic pre-existing degeneration of adjacent segment: a retrospective case-control study. — Zhang X, Zhu J, Li Y, Hao D, Gao W BMC surgery (2021)
    18. [18]
      Lumbosacral transitional vertebrae are associated with lumbar degeneration: retrospective evaluation of 3855 consecutive abdominal CT scans. — Hanhivaara J, Määttä JH, Niinimäki J, Nevalainen MT European radiology (2020)
    19. [19]
      Finite element modelling of hybrid stabilization systems for the human lumbar spine. — Demir E, Eltes P, Castro AP, Lacroix D, Toktaş İ Proceedings of the Institution of Mechanical Engineers. Part H, Journal of engineering in medicine (2020)
    20. [20]
      Adjacent Intervertebral Disk Height Decrease Phenomenon After Single-Level Transforaminal Lumbar Interbody Fusion of the Lumbar Spine. — Zou F, Yang S, Jiang J, Lu F, Xia X, Ma X World neurosurgery (2019)
    21. [21]
      Lumbar Schmorl's Nodes and Their Correlation with Spine Configuration and Degeneration. — Abbas J, Hamoud K, Peled N, Hershkovitz I BioMed research international (2018)
    22. [22]
      Association Between Lumbar Spinal Degeneration and Anatomic Pelvic Parameters. — Strube P, Pumberger M, Sonnow L, Zippelius T, Nowack D, Zahn RK et al. Clinical spine surgery (2018)
    23. [23]
      In vivo study of paraspinal muscle weakness using botulinum toxin in one primate model. — Han SK, Lee Y, Hong JJ, Yeo HG, Seo J, Jeon CY et al. Clinical biomechanics (Bristol, Avon) (2018)
    24. [24]
      Stand-Alone Anterolateral Interbody Fusion Versus Extended Posterior Fusion for Symptomatic Adjacent-Segment Degeneration: A Retrospective Study of 2 Years' Follow-up. — Tu Z, Li L, Wang B, Li Y, Lv G, Dai Y World neurosurgery (2018)
    25. [25]
      Associations between lumbosacral transitional anatomy types and degeneration at the transitional and adjacent segments. — Farshad-Amacker NA, Herzog RJ, Hughes AP, Aichmair A, Farshad M The spine journal : official journal of the North American Spine Society (2015)
    26. [26]
      Systematic literature review of imaging features of spinal degeneration in asymptomatic populations. — Brinjikji W, Luetmer PH, Comstock B, Bresnahan BW, Chen LE, Deyo RA et al. AJNR. American journal of neuroradiology (2015)
    27. [27]
      Thoracic range of motion, stability, and correlation to imaging-determined degeneration. — Healy AT, Mageswaran P, Lubelski D, Rosenbaum BP, Matheus V, Benzel EC et al. Journal of neurosurgery. Spine (2015)
    28. [28]
      Biomechanical assessment of a novel L4/5 level interspinous implant using three dimensional finite element analysis. — Song C, Li XF, Liu ZD, Zhong GB European review for medical and pharmacological sciences (2014)
    29. [29]
      Kinetic magnetic resonance imaging analysis of spinal degeneration: a systematic review. — Lao LF, Zhong GB, Li QY, Liu ZD Orthopaedic surgery (2014)
    30. [30]
      The protective role of dynamic stabilization on the adjacent disc to a rigid instrumented level. An in vitro biomechanical analysis. — Cabello J, Cavanilles-Walker JM, Iborra M, Ubierna MT, Covaro A, Roca J Archives of orthopaedic and trauma surgery (2013)
    31. [31]
      Does TLIF aggravate adjacent segmental degeneration more adversely than ALIF? A finite element study. — Tang S Turkish neurosurgery (2012)
    32. [32]
      Spine degeneration in a murine model of chronic human tobacco smokers. — Wang D, Nasto LA, Roughley P, Leme AS, Houghton AM, Usas A et al. Osteoarthritis and cartilage (2012)
    33. [33]
      The natural history of degeneration of the lumbar and cervical spines: a systematic review. — Lee MJ, Dettori JR, Standaert CJ, Brodt ED, Chapman JR Spine (2012)
    34. [34]
      Association between computed tomography-evaluated lumbar lordosis and features of spinal degeneration, evaluated in supine position. — Kalichman L, Li L, Hunter DJ, Been E The spine journal : official journal of the North American Spine Society (2011)
    35. [35]
      Effects of advanced age on the morphometry and degenerative state of the cervical spine in a rat model. — Laing AC, Cox R, Tetzlaff W, Oxland T Anatomical record (Hoboken, N.J. : 2007) (2011)
    36. [36]
      Finite element analysis in adjacent segment degeneration after lumbar fusion. — Yan JZ, Qiu GX, Wu ZH, Wang XS, Xing ZJ The international journal of medical robotics + computer assisted surgery : MRCAS (2011)
    37. [37]
      Lumbar segmental mobility according to the grade of the disc, the facet joint, the muscle, and the ligament pathology by using kinetic magnetic resonance imaging. — Kong MH, Morishita Y, He W, Miyazaki M, Zhang H, Wu G et al. Spine (2009)
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