scholarly journals Disc Space Excessive Distraction is a Potent Risk Factor for Adjacent Segment Degeneration after Anterior Cervical Discectomy and Fusion

2014 ◽  
Vol 4 (1_suppl) ◽  
pp. s-0034-1376591-s-0034-1376591
Author(s):  
X. Huang ◽  
F. Li ◽  
H. Shen ◽  
M. Li
Keyword(s):  
Risk Factor ◽  
Adjacent Segment Degeneration ◽  
Anterior Cervical Discectomy ◽  
Adjacent Segment ◽  
Disc Space ◽  
Cervical Discectomy

scholarly journals Risk factor analysis of axial symptoms after single-segment anterior cervical discectomy and fusion: A retrospective study of 113 patients

2019 ◽  
Vol 47 (12) ◽  
pp. 6100-6108
Author(s):  
Lin-Feng Wang ◽  
Zhen Dong ◽  
De-Chao Miao ◽  
Yong Shen ◽  
Feng Wang
Keyword(s):  
Risk Factor ◽  
Retrospective Study ◽  
Japanese Orthopaedic Association ◽  
Anterior Cervical Discectomy ◽  
Occurrence Rate ◽  
Adjacent Segment ◽  
Disc Space ◽  
Cervical Discectomy ◽  
Single Segment ◽  
Axial Symptoms

Objective This retrospective study was performed to investigate the risk factors for axial symptoms (AS) after single-segment anterior cervical discectomy and fusion (ACDF). Methods One hundred thirteen patients with cervical spondylosis who had undergone single-segment ACDF from January 2012 to December 2015 were divided into those with and without AS (n = 34 and n = 79, respectively). Clinical data and radiological evaluation results were recorded. Results The occurrence rate of AS was 30.1% (34/113), and the average visual analog scale score was 4.5 points. Bony fusion was achieved in all cases during follow-up. There were no differences in age, sex, disease duration, diagnostic categories, operative segment, Japanese Orthopaedic Association score, or adjacent segment degeneration. However, cervical range of motion (CROM), cervical curvature, and disc space enlargement significantly differed between the groups. Logistic regression analysis revealed that CROM, cervical curvature, and disc space enlargement were independently associated with AS. Conclusions AS after single-segment ACDF is not rare. Disc space enlargement is a risk factor for AS, while higher CROM and lordotic cervical curvature are protective factors. Excessive or insufficient disc space enlargement could increase the incidence of AS. Maintaining CROM within the normal range and restoring cervical lordosis might help to prevent AS.

Biomechanical Changes at Adjacent-Level Segments After Anterior Cervical Discectomy and Fusion

2003 ◽  
Author(s):  
R. N. Natarajan ◽  
G. B. J. Andersson ◽  
H. S. An
Keyword(s):  
Adjacent Segment Degeneration ◽  
Anterior Cervical Discectomy ◽  
Adjacent Segment ◽  
Exact Nature ◽  
Adjacent Level ◽  
Cervical Discectomy ◽  
Upper Cervical ◽  
Biomechanical Changes ◽  
Level Fusion ◽  
Element Study

It is well documented that there is significant motion in the unfused segments above and below a fused segment during anterior cervical discectomy and fusion but exact nature of this motion is not well known. The current finite element study showed that likelihood of adjacent segment degeneration is higher in a two level fusion than a one level fusion. Also, the analyses showed that two level fusion at upper cervical levels more likely to degenerate above and below than two level fusion at lower cervical levels.

Cervical Spine Endplate Abnormalities and Association With Pain, Disability, and Adjacent Segment Degeneration After Anterior Cervical Discectomy and Fusion

Spine ◽  
2020 ◽  
Vol 45 (15) ◽  
pp. E917-E926
Author(s):  
Garrett K. Harada ◽  
Kevin Alter ◽  
Austin Q. Nguyen ◽  
Youping Tao ◽  
Philip K. Louie ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Adjacent Segment Degeneration ◽  
Anterior Cervical Discectomy ◽  
Adjacent Segment ◽  
Cervical Discectomy ◽  
Pain Disability

scholarly journals Is the improvement of cervical alignment really essential after three-level anterior cervical discectomy and fusion? A minimal 5-year follow-up

2020 ◽  
Author(s):  
Yan Liang ◽  
Shuai Xu ◽  
Guanjie Yu ◽  
Zhenqi Zhu ◽  
Haiying Liu
Keyword(s):  
Japanese Orthopaedic Association ◽  
Neck Disability Index ◽  
Adjacent Segment Degeneration ◽  
Anterior Cervical Discectomy ◽  
Adjacent Segment ◽  
Cervical Discectomy ◽  
Cervical Alignment ◽  
Neck Disability

Abstract Purpose: To identify the importance of sagittal alignment with self-locked stand-alone cage (SSC) and anterior cage-with-plate (ACP) system after 3-level anterior cervical discectomy and fusion (ACDF) on cervical spondylotic myelopathy (CSM) after minimal 5-year follow-up.Methods: 38 patients with SSC system (SSC group) and 26 with ACP system (ACP group) from February 2007 to September 2013 were enrolled. Cervical alignment were C2-7 lordosis (CL), operated-segment CL (OPCL), upper and lower adjacent-segment CL (UCL and LCL) at preoperation (POP), immediate postoperation (IPO) and final follow-up (FFU). Clinical outcomes contained the neck disability index (NDI), the Japanese Orthopaedic Association (JOA) score and adjacent segment degeneration (ASD). Patients were divides into CL improved subgroup (IM subgroup) and non-improved subgroup (NIM subgroup).Results: There were improvements on CL and OPCL in both groups. The change of CL and OPCL larger in ACP group (P<0.05) but UAL and LAL were of no significance. NDI and JOA got improvement in both groups at IPO and FFU while ASD was in no difference between SSC and ACP. A total of 40 patients (18 vs 22) acquired CL improvement with a larger population in ACP group. There were no differences on the rate if ASD, NDI, JOA and their change between IM and NIM subgroup and the change of CL were not correlated with NDI, JOA and their change.Conclusion: SSC and ACP both provide long-term efficacy on OPCL correction with little impact on adjacent segment. The improvement of CL after three-level ACDF seems not so essential.

Rotational vertebral artery occlusion secondary to adjacent-level degeneration following anterior cervical discectomy and fusion

2014 ◽  
Vol 20 (6) ◽  
pp. 714-721 ◽  
Author(s):  
Colin C. Buchanan ◽  
Nancy McLaughlin ◽  
Daniel C. Lu ◽  
Neil A. Martin
Keyword(s):  
Vertebral Artery ◽  
Head Rotation ◽  
Artery Occlusion ◽  
Adjacent Segment Degeneration ◽  
Anterior Cervical Discectomy ◽  
Herniated Disc ◽  
Adjacent Segment ◽  
Vertebrobasilar Insufficiency ◽  
Cervical Discectomy ◽  
Vertebral Artery Occlusion

Rotational vertebral artery occlusion (RVAO), or bow hunter's syndrome, most often occurs at the C1–2 level on physiological head rotation. It presents with symptoms of vertebrobasilar insufficiency (VBI). Several previously published studies have reported on subaxial sites of vertebral artery (VA) compression by head rotation. The authors report a case of subaxial spine RVAO due to adjacent-segment degeneration. A 52-year-old man presented with dizziness when rotating his head to the left. Twenty years earlier, he had undergone a C4–5 anterior cervical discectomy and fusion (ACDF) for a herniated disc. Imaging studies including a dynamic CT angiography and dynamic catheter angiography revealed occlusion of the left VA at the C3–4 level when the patient turned his head to the left, in the setting of an aberrant vertebrobasilar system. Successful treatment was achieved by surgical decompression of the left VA and C3–4 ACDF. Expedited diagnosis and treatment are dependent on the recognition of this unusual manifestation of RVAO, especially when patients present with nonspecific symptoms of VBI.

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