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KMID : 0388720100170010001
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Journal of Korean Society of Spine Surgery
2010 Volume.17 No. 1 p.1 ~ p.6
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Prevalence And Risk Factor of Degenerative Disease of Adjacent Segment after Anterior Cervical Arthrodesis
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Kim Yung-Tae
Baek Dong-Hoon
Lee Chun-Sung
Lee Dong-Ho
Hwang Chang-Ju
Sohn Dong-Wook
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Abstract
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Study Design: A retrospective radiologic and clinical analysis of 48 patients following anterior cervical fusion.
Objectives: To examine the prevalence of symptomatic adjacent segment disease after anterior cervical fusion and determine the risk factors affecting its progression.
Summary of Literature Review: Symptomatic adjacent segment disease appears to occur at a rate of 2% to 3% per year.
Materials and Methods: Forty-eight patients, who were followed up for more than 3 years after anterior cervical arthrodesis, were enrolled in this study. A modification of the Robinson criteria was used for the clinical evaluation and the radiographic grading of Hilibrand was used for the radiology evaluation. Kaplan-Meier survival analysis was used to examine the survival rate. Age, gender, number of fusion segments, preoperative ROM, angle of lordosis, spinal canal diameter and radiologic degeneration of adjacent segments were selected as potential risk factors. The subjects were divided into two groups according to their clinical symptoms.
Results: Symptomatic adjacent segment disease developed in 11 of the 48 patients(22.9%). The disease free survival rates were 88.7%, 82.4% and 58.7% at 5, 10 and 15 years, respectively. A study of the risk factors showed that preoperative degenerative changes and narrow spinal canal in the adjacent segments were significant. However, there were no significant associations with age, gender, number of fusion segments, preoperative ROM and angle of lordosis.
Conclusion: The prevalence of symptomatic adjacent segment disease after anterior cervical fusion was considerable and higher when the patients had preoperative degenerative changes and a narrow spinal canal in the adjacent segments.
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KEYWORD
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Cervical spine, Anterior fusion, Adjacent segment disease, Prevalence, Risk factor
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