1. Radiologic Findings and Risk Factors of Adjacent Segment Degeneration after Anterior Cervical Discectomy and Fusion : A Retrospective Matched Cohort Study with 3-Year Follow-Up Using MRI
- Author
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Sang Soak Ahn, Sanghyeon Kim, Byung Hun Lee, Wan Soo So, Min Geun Ku, and Dong Won Kim
- Subjects
Adjacent segment ,medicine.medical_specialty ,genetic structures ,Radiography ,Anterior cervical discectomy and fusion ,Computed tomography ,Degeneration (medical) ,behavioral disciplines and activities ,03 medical and health sciences ,0302 clinical medicine ,Text mining ,Matched cohort ,mental disorders ,medicine ,Fusion ,Anterior ,030222 orthopedics ,Clinical Article ,medicine.diagnostic_test ,business.industry ,General Neuroscience ,Magnetic resonance imaging ,Surgery ,Adjacent segment degeneration ,Cervical ,Spondylosis ,Neurology (clinical) ,Radiology ,business ,030217 neurology & neurosurgery - Abstract
Objective The purpose of this study was to figure out the radiologic findings and risk factors related to adjacent segment degeneration (ASD) after anterior cervical discectomy and fusion (ACDF) using 3-year follow-up radiography, computed tomography (CT), and magnetic resonance image (MRI). Methods A retrospective matched comparative study was performed for 64 patients who underwent single-level ACDF with a cage and plate. Radiologic parameters, including upper segment range of motion (USROM), lower segment range of motion (LSROM), upper segment disc height (UDH), and lower segment disc height (LDH), clinical outcomes assessed with neck and arm visual analogue scale (VAS), and risk factors were analyzed. Results Patients were categorized into the ASD (32 patients) and non-ASD (32 patients) group. The decrease of UDH was significantly greater in the ASD group at each follow-up visit. At 36 months postoperatively, the difference for USROM value from the preoperative one significantly increased in the ASD group than non-ASD group. Preoperative other segment degeneration was significantly associated with the increased incidence of ASD at 36 months. However, pain intensity for the neck and arm was not significantly different between groups at any post-operative follow-up visit. Conclusion The main factor affecting ASD is preoperative other segment degeneration out of the adjacent segment. In addition, patients over the age of 50 are at higher risk of developing ASD. Although there was definite radiologic degeneration in the ASD group, no significant difference was observed between the ASD and non-ASD groups in terms of the incidence of symptomatic disease.
- Published
- 2016
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