Congenital Stenosis and Adjacent Segment Disease in the Cervical Spine
Adult
Aged, 80 and over
Male
Adolescent
Incidence
Middle Aged
United States
3. Good health
Young Adult
03 medical and health sciences
Postoperative Complications
Spinal Fusion
Spinal Stenosis
0302 clinical medicine
Cervical Vertebrae
Humans
Female
Aged
Retrospective Studies
DOI:
10.3928/01477447-20130920-15
Publication Date:
2014-08-19T21:03:18Z
AUTHORS (14)
ABSTRACT
Symptomatic adjacent segment disease (ASD) after anterior cervical fusion (ACF) is reported in 25% of patients at 10 years postoperatively. Debate continues as to whether this degeneration is due to the natural history of the disk or the changed biomechanics after ACF. This study explored whether congenital stenosis predisposes patients to an increased incidence of ASD after ACF.
A retrospective review of 635 patients with myelopathy or radiculopathy was performed; 364 patients had complete records for review. Patients underwent 1- to 5-level ACF (94 one-level, 145 two-level, 79 three-level, 45 four-level, and 1 five-level). Radiographs were evaluated for bony congenital stenosis using validated parameters, and ASD was measured according to Hilibrand’s criteria and correlated with symptomatic ASD. Congenital stenosis was found in 21.7% of patients and radiographic ASD in 33.5%, with a significant association between these parameters. However, symptomatic ASD occurred in 11.8% of patients; no association between congenital stenosis and symptomatic ASD or myelopathy and ASD was found. Clinical results demonstrated excellent or good Robinson scores in 86.2% of patients and Odom scores in 87% of patients.
Despite mostly excellent to good outcomes, symptomatic ASD is common after ACF. Although congenital stenosis appears to increase the incidence of radiographic ASD, it does not appear to predict symptomatic ASD.
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