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Intermediate segment degeneration after noncontiguous anterior cervical fusion
Erica F Bisson1, Mical M Samuelson, Ronald I Apfelbaum
1Department of Neurosurgery, University of Utah, 175 N. Medical Drive East, Salt Lake City, UT 84132, USA. neuropub@hsc.utah.edu
Acta Neurochirurgica
|October 9, 2010
Summary
Noncontiguous anterior cervical fusion did not increase symptomatic adjacent segment disease (ASD) in intervening segments. This surgical approach demonstrated safety and effectiveness, with patients experiencing neurological and clinical improvement.
Area of Science:
- Neurosurgery
- Spine Surgery
- Orthopedics
Background:
- Adjacent segment disease (ASD) affects 2-3% of patients annually.
- Increased stress at fusion levels may necessitate including normal segments in fusion constructs for noncontiguous cervical spondylosis.
- Evaluating ASD incidence in intermediate segments of noncontiguous anterior cervical fusion is crucial.
Purpose of the Study:
- To assess the incidence of symptomatic adjacent segment disease (ASD) in the intermediate segments of noncontiguous anterior cervical fusions.
- To evaluate the safety and effectiveness of noncontiguous anterior cervical fusion for treating cervical spondylosis.
Main Methods:
- Retrospective review of patients undergoing noncontiguous anterior cervical arthrodesis (1985-2007).
- Primary outcome: symptomatic degeneration at the intermediate segment.
- Secondary outcomes: Visual Analog Scale (VAS) scores and neurologic outcomes.
Main Results:
- No symptomatic ASD observed at the intervening level in 17 patients (mean follow-up: 26 months).
- 13 of 17 patients showed postoperative neurological improvement.
- Significant improvement in VAS scores and overall clinical outcomes.
Conclusions:
- Noncontiguous anterior cervical fusion is safe and effective.
- This technique does not increase postoperative or long-term morbidity.
- Patients experience neurological and clinical improvement without increased degeneration at the intermediate segment.
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