Asian Spine J.  2014 Dec;8(6):720-728. 10.4184/asj.2014.8.6.720.

Adjacent Segment Pathology Following Anterior Decompression and Fusion Using Cage and Plate for the Treatment of Degenerative Cervical Spinal Diseases

• Song KJ
• Choi BW
• Kim JK

• KMID: 2270212
• DOI: http://doi.org/10.4184/asj.2014.8.6.720

Abstract

STUDY DESIGN: Retrospective study. PURPOSE: To analyze the incidence and prevalence of clinical adjacent segment pathology (CASP) following anterior decompression and fusion with cage and plate augmentation for degenerative cervical diseases. OVERVIEW OF LITERATURE: No long-term data on the use of cage and plate augmentation have been reported.
METHODS
The study population consisted of 231 patients who underwent anterior cervical discectomy and fusion (ACDF) with cage and plate for degenerative cervical spinal disease. The incidence and prevalence of CASP was determined by using the Kaplan-Meier survival analysis. To analyze the factors that influence CASP, data on preoperative and postoperative sagittal alignment, spinal canal diameter, the distance between the plate and adjacent disc, extent of fusion level, and the presence or absence of adjacent segment degenerative changes by imaging studies were evaluated.
RESULTS
CASP occurred in 15 of the cases, of which 9 required additional surgery. At 8-year follow-up, the average yearly incidence was 1.1%. The rate of disease-free survival based on Kaplan-Meier survival analysis was 93.6% at 5 years and 90.2% at 8 years. No statistically significant differences in CASP incidence based on radiological analysis were observed. Significantly high incidence of CASP was observed in the presence of increased adjacent segment degenerative changes (p<0.001).
CONCLUSIONS
ACDF with cage and plate for the treatment of degenerative cervical disease is associated with a lower incidence in CSAP by 1.1% per year, and the extent of preoperative adjacent segment degenerative changes has been shown as a risk factor for CASP.

Keyword

Degenerative cervical spine disease; Anterior cervical discectomy and fusion; Adjacent segment pathology; Cage and plate

MeSH Terms

Decompression*
Disease-Free Survival
Diskectomy
Follow-Up Studies
Humans
Incidence
Pathology*
Prevalence
Retrospective Studies
Risk Factors
Spinal Canal
Spinal Diseases*