Prevalence And Risk Factor of Degenerative Disease of Adjacent Segment after Anterior Cervical Arthrodesis (경추 전방 유합술 후 인접 분절 퇴행성 병변의 발병률과 위험인자)

김영태; 백동훈; Choon Sung Lee (이춘성); Dong-Ho Lee (이동호); Chang Ju Hwang (황창주); 손동욱

Prevalence And Risk Factor of Degenerative Disease of Adjacent Segment after Anterior Cervical Arthrodesis

Journal of Korean Society of Spine Surgery
Abbr : J Kor Spine Sur
2010, 17(1), pp.1-6
Publisher : Korean Society Of Spine Surgery
Research Area : Medicine and Pharmacy > Orthopedic Surgery

김영태 ¹, 백동훈 ¹, Choon Sung Lee ¹, Dong-Ho Lee ¹, Chang Ju Hwang ¹, 손동욱 ¹

¹울산대학교의과대학 서울아산병원 정형외과

Accredited

ABSTRACT

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.

KEYWORDS

Cervical spine, Anterior fusion, Adjacent segment disease, Prevalence, Risk factor

Citation status

* References for papers published after 2023 are currently being built.

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