scholarly journals Comparison of Adjacent Segment Degeneration, Cervical Alignment, and Clinical Outcomes After One- and Multilevel Anterior Cervical Discectomy and Fusion

Neurospine ◽  
2019 ◽  
Vol 16 (3) ◽  
pp. 589-600 ◽  
Author(s):  
Jun Jae Shin
Keyword(s):  
Clinical Outcomes ◽  
Adjacent Segment Degeneration ◽  
Anterior Cervical Discectomy ◽  
Adjacent Segment ◽  
Cervical Discectomy ◽  
Cervical Alignment

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.

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 Clinical Outcomes of Treating Cervical Adjacent Segment Disease by Anterior Cervical Discectomy and Fusion Versus Total Disc Replacement: A Systematic Review and Meta-Analysis

2018 ◽  
Vol 9 (5) ◽  
pp. 559-567 ◽  
Author(s):  
Victor M. Lu ◽  
Ralph J. Mobbs ◽  
Kevin Phan
Keyword(s):  
Systematic Review ◽  
Clinical Outcomes ◽  
Visual Analog Scale ◽  
Systematic Reviews ◽  
Meta Analysis ◽  
Total Disc Replacement ◽  
Anterior Cervical Discectomy ◽  
Adjacent Segment ◽  
Analog Scale ◽  
Cervical Discectomy

Study Design: Systematic review and meta-analysis. Objective: To compare clinical outcomes of all available adjacent segment disease (ASD) cohorts being treated by either anterior cervical discectomy and fusion (ACDF) or total disc replacement (TDR). Methods: We followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines for systematic reviews. Searches of electronic databases from inception to August 2017 identified 349 articles for screening. Data was extracted and analyzed using meta-analysis of proportions. Results: The search identified 1 double-armed study and 8 single-armed studies from which data of 5 TDR and 5 ACDF cohorts treating ASD were extracted. Between the 2 pooled TDR (n = 103) and ACDF (n = 258) groups, baseline characteristics were predominantly similar. Compared with ACDF, TDR demonstrated superior operation duration (107 vs 188 minutes, P = .011) and range of motion of C2-C7 at final follow-up at least 1 year after surgery (40.2° vs 35.1°, P = .001). Other surgical and performance parameters including estimated blood loss, complications, and Japanese Orthopedic Association score, Neck Disability Index, Visual Analog Scale neck, and Visual Analog Scale upper limb measures were comparable between cohorts. Conclusion: TDR confers similar surgical and postoperative outcomes to the treatment of ASD as ACDF. Both procedures lead to improvement in all performance outcomes. Larger, prospective, randomized studies will validate the findings of this meta-analysis. Longer term studies are required to ascertain the recurrence rates of ASD following either surgical treatment of primary ASD.

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