Abstract
Adjacent segment pathology affects 25% of patients within ten years of anterior cervical diskectomy and fusion (ACDF). Laboratory studies demonstrate fused segments increase adjacent level stress including elevated intradiscal pressure and increased range of motion. Radiographic adjacent segment pathology (RASP) has been associated to ACDF in multiple statistically significant studies. Randomized controlled trials (RCTs) comparing anterior cervical discectomy and arthroplasty (ACDA) and ACDF have confirmed ACDF accelerates RASP. The question of greatest clinical interest is whether ACDA, artificial disc surgery, results in fewer adjacent level surgeries than ACDF. Current RCT follow up results reveal only non statistically significant trends favoring ACDA yet the post operative periods are only two to four years. Statistically significant increased RASP in ACDF patients however is already documented. The RCT patients' average ages are in the mid forties with an expected longevity of up to forty more years. Early statistically significant increased RASP in the ACDF patients supports our prediction that given sufficient follow up of ten or more years, fusion will lead to statistically significant higher rate of adjacent level surgery compared to artificial disc surgery.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 112-113 |
| Number of pages | 2 |
| Journal | World Journal of Orthopaedics |
| Volume | 4 |
| Issue number | 3 |
| DOIs | |
| State | Published - Jul 18 2013 |
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Keywords
- Adjacent
- Arthroplasty
- Cervical
- Degeneration
- Diskectomy
- Fusion
ASJC Scopus subject areas
- Orthopedics and Sports Medicine
Cite this
Cervical adjacent segment pathology following fusion : Is it due to fusion? / Rosenthal, Philip; Kim, Kee D.
In: World Journal of Orthopaedics, Vol. 4, No. 3, 18.07.2013, p. 112-113.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Cervical adjacent segment pathology following fusion
T2 - Is it due to fusion?
AU - Rosenthal, Philip
AU - Kim, Kee D
PY - 2013/7/18
Y1 - 2013/7/18
N2 - Adjacent segment pathology affects 25% of patients within ten years of anterior cervical diskectomy and fusion (ACDF). Laboratory studies demonstrate fused segments increase adjacent level stress including elevated intradiscal pressure and increased range of motion. Radiographic adjacent segment pathology (RASP) has been associated to ACDF in multiple statistically significant studies. Randomized controlled trials (RCTs) comparing anterior cervical discectomy and arthroplasty (ACDA) and ACDF have confirmed ACDF accelerates RASP. The question of greatest clinical interest is whether ACDA, artificial disc surgery, results in fewer adjacent level surgeries than ACDF. Current RCT follow up results reveal only non statistically significant trends favoring ACDA yet the post operative periods are only two to four years. Statistically significant increased RASP in ACDF patients however is already documented. The RCT patients' average ages are in the mid forties with an expected longevity of up to forty more years. Early statistically significant increased RASP in the ACDF patients supports our prediction that given sufficient follow up of ten or more years, fusion will lead to statistically significant higher rate of adjacent level surgery compared to artificial disc surgery.
AB - Adjacent segment pathology affects 25% of patients within ten years of anterior cervical diskectomy and fusion (ACDF). Laboratory studies demonstrate fused segments increase adjacent level stress including elevated intradiscal pressure and increased range of motion. Radiographic adjacent segment pathology (RASP) has been associated to ACDF in multiple statistically significant studies. Randomized controlled trials (RCTs) comparing anterior cervical discectomy and arthroplasty (ACDA) and ACDF have confirmed ACDF accelerates RASP. The question of greatest clinical interest is whether ACDA, artificial disc surgery, results in fewer adjacent level surgeries than ACDF. Current RCT follow up results reveal only non statistically significant trends favoring ACDA yet the post operative periods are only two to four years. Statistically significant increased RASP in ACDF patients however is already documented. The RCT patients' average ages are in the mid forties with an expected longevity of up to forty more years. Early statistically significant increased RASP in the ACDF patients supports our prediction that given sufficient follow up of ten or more years, fusion will lead to statistically significant higher rate of adjacent level surgery compared to artificial disc surgery.
KW - Adjacent
KW - Arthroplasty
KW - Cervical
KW - Degeneration
KW - Diskectomy
KW - Fusion
UR - http://www.scopus.com/inward/record.url?scp=84892966151&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84892966151&partnerID=8YFLogxK
U2 - 10.5312/wjo.v4.i3.112
DO - 10.5312/wjo.v4.i3.112
M3 - Article
AN - SCOPUS:84892966151
VL - 4
SP - 112
EP - 113
JO - World Journal of Orthopaedics
JF - World Journal of Orthopaedics
SN - 2218-5836
IS - 3
ER -