Volume 27, Issue 3
DOI: 53555/03276716.2018.1077
Evaluation of the Effects of Fusion Surgeries Applied in Degenerative Cervical Spine Diseases on the Development of Adjacent Segment Disease with Clinical and Radiological Findings
Abstract
Aims: Cervical fusion is one of the most frequent procedures to treat degenerative disease of the cervical spine, but the emergence of specific pathogen-free adjacent segment disease (ASD) is one of the most critical issues after surgery. Our study aims to evaluate the adjacent segment changes after cervical spine surgery with a focus on ASD and its sharing factors.
Methods: Our study designed as a retrospective study of patients who underwent cervical spine surgery from January 2017 to January 2018 at Private Kocaeli Academy Hospital, Department of Neurosurgery. Celebrate and validation of clinical predictors of outcome, combined scoring system of Neck Disability Index (NDI) and Visual Analog Scale (VAS) among patients on methods study. Clinical assessments pain assessment was carried out using the VAS and NDI. Radiological data using x-ray, computarized tomography (CT), and magnetic resonance imaging (MRI) to determine disc height, cervical lordosis, and the presence of ASD were evaluated.
Results: In our study 150 patients (mean age 47.5 years) were identified. Patients had a mean VAS of 7.5 preoperatively which dropped to 3.1 postoperatively, and a mean NDI of 45 preoperatively which improved to 15 postoperatively (all p < 0.001). However, both VAS (4.8) and NDI (25) scores after surgery were significantly higher for patients with ASD (n=45) than for those without ASD. Radiographically, disc height improved (from 5.2 to 7.5 mm, p < 0.001) as did cervical lordosis (from 12.5° to 8.3°, p < 0.05). Overall, the incidence of ASD was 30%, mainly occurring at the C5-C6 level (33.3%). A specifically impressive finding was that at follow-up, 70% of patients had neither degenerative disease nor disc herniation of adjacent level radiculopathy (30%) and disc herniation (16.7%) were common at adjacent levels.
Conclusion: The cervical spine fusion surgery can improve outcomes in terms of pain and disability, but ASD is a real problem postoperatively. These results highlight the need for long-term follow-up and preventive intervention for degenerative changes at adjacent segments.
Keywords
adjacent segment disease, cervical spine surgery, cervical fusion, degenerative cervical spine disease