1. Multi- versus single-level anterior cervical discectomy and fusion: comparing sagittal alignment, early adjacent segment degeneration, and clinical outcomes
- Author
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Howard S. An, Jeremy D. Mormol, Jannat M. Khan, Justin C. Paul, Kamran Movassaghi, Arya G. Varthi, Edward J. Goldberg, Philip K. Louie, and Bryce A. Basques
- Subjects
medicine.medical_specialty ,Lordosis ,Radiography ,Anterior cervical discectomy and fusion ,Degeneration (medical) ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Humans ,Sagittal alignment ,Orthopedics and Sports Medicine ,Patient Reported Outcome Measures ,Retrospective Studies ,030222 orthopedics ,business.industry ,Retrospective cohort study ,medicine.disease ,Sagittal plane ,Surgery ,Spinal Fusion ,medicine.anatomical_structure ,Cervical Vertebrae ,Neurosurgery ,business ,030217 neurology & neurosurgery ,Diskectomy - Abstract
The purpose of this study was to compare the rates of adjacent segment degeneration (ASD), sagittal alignment parameters, and patient-reported outcomes in patients who underwent multi-level versus single-level anterior cervical discectomy and fusion (ACDF). A retrospective cohort analysis was performed on consecutive patients who underwent an ACDF. Pre- and post-operative radiographic assessment included ASD, change in C2–C7 lordosis, T1 angle, levels fused, sagittal vertical axis (SVA), fusion mass lordosis, proximal and distal adjacent segment lordosis. Patient-reported outcomes were obtained. Of the 404 that underwent an ACDF with a minimum of 6 months of follow-up (average 28 months), there was no significant difference in the rate of radiographic ASD overall (p = 0.479) or in the proximal or distal adjacent segments on multivariate analysis. Secondarily, the multi-level fusions appear to restore significantly greater amounts of lordosis compared to single-level procedures (p
- Published
- 2018
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