biostudies-literatureUnknown25McNamee C<h4>Background</h4>Facet joint violation (FJV) is a recognized complication of pedicle screw fixation and has been proposed as a driver of adjacent segment disease (ASD). Biomechanical models suggest that FJV may alter segmental kinematics, but its clinical impact on degeneration and reoperation remains uncertain. This work evaluates whether superior FJV is associated with an increased risk of radiographic ASD or reoperation after lumbar fusion.<h4>Methods</h4>Retrospective cohort study of patients undergoing lumbar pedicle screw fixation with postoperative CT imaging that captured the instrumentation and the cranial adjacent segment. Superior FJV was graded using an established 3-tier system. Follow-up imaging was assessed for disc height loss, progression of spondylolisthesis, coronal deNorth American Spine Society journal100843https://www.ebi.ac.uk/biostudies/studies/S-EPMC12854983biostudies-literatureAdjacent segment degeneration after superior facet joint violation of the lumbar spine.PMC12854983McNamee CMagee BMcDonnell JMDarwish SButler JSStorey RNfalseAdjacent segment degeneration after superior facet joint violation of the lumbar spine.<h4>Background</h4>Facet joint violation (FJV) is a recognized complication of pedicle screw fixation and has been proposed as a driver of adjacent segment disease (ASD). Biomechanical models suggest that FJV may alter segmental kinematics, but its clinical impact on degeneration and reoperation remains uncertain. This work evaluates whether superior FJV is associated with an increased risk of radiographic ASD or reoperation after lumbar fusion.<h4>Methods</h4>Retrospective cohort study of patients undergoing lumbar pedicle screw fixation with postoperative CT imaging that captured the instrumentation and the cranial adjacent segment. Superior FJV was graded using an established 3-tier system. Follow-up imaging was assessed for disc height loss, progression of spondylolisthesis, coronal de2026-01-01T00:00:00Z2026 Mar2026-06-19T03:15:46.138Z2026-06-19T03:07:37.802ZS-EPMC128549834162425910.1016/j.xnsj.2025.100843