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Adjacent segment disease after cervical spine fusion
Jeffrey A Rihn1, James Lawrence, Charley Gates
1Department of Orthopedic Surgery, Rothman Institute, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA.
Instructional Course Lectures
|April 24, 2009
Summary
Adjacent segment cervical disease is a concern after anterior cervical diskectomy and fusion (ACDF). New motion-sparing technologies aim to reduce the incidence of this common complication.
Area of Science:
- Orthopedics
- Neurosurgery
- Spine Surgery
Background:
- Anterior cervical diskectomy and fusion (ACDF) is a common procedure for cervical spine issues.
- Adjacent segment disease (ASD) can develop after ACDF, affecting up to 25% of patients within 10 years.
- The exact cause of ASD is debated, likely involving biomechanical stress and natural disease progression.
Purpose of the Study:
- To review the incidence, causes, and management of adjacent segment disease after cervical spine fusion.
- To discuss the development and potential benefits of motion-sparing technologies in preventing ASD.
Main Methods:
- Literature review of clinical and biomechanical studies on cervical spine fusion and adjacent segment disease.
- Analysis of data regarding the incidence and progression of ASD.
- Evaluation of emerging motion-sparing technologies, including cervical disk replacement systems.
Main Results:
- ASD is a significant concern following ACDF, with increasing incidence over time.
- Both increased biomechanical stress and the natural history of cervical spondylosis contribute to ASD.
- Two FDA-approved cervical disk replacement systems offer motion-sparing alternatives.
Conclusions:
- Adjacent segment disease remains a clinical challenge after cervical fusion.
- Motion-sparing technologies represent a promising approach to mitigate the risk of ASD.
- Further research and clinical data are needed to fully understand the long-term impact of cervical disk replacement.
