Related Experiment Video
Updated: Jun 29, 2026
05:30
Surgical Approach and Complications of Stand-alone Lateral Trans-Psoas Interbody Fusion
Published on: February 14, 2025
1.4K
Functional Outcomes Associated With Adjacent-level Ossification Disease 10 Years After Cervical Disc Arthroplasty or
Barrett S Boody1, Evan N Lee1,2, Willa R Sasso1,3
1Indiana Spine Group, Indianapolis, IN.
Clinical Spine Surgery
|March 10, 2020
Summary
Adjacent-level ossification disease (ALOD) is more common after cervical fusion than disc arthroplasty, but does not impact long-term patient outcomes. This study found no significant difference in functional outcomes between patients with or without ALOD at 10-year follow-up.
Area of Science:
- Spine surgery
- Orthopedics
- Biomaterials
Background:
- Adjacent-level ossification disease (ALOD) involves calcification of spinal ligaments and annulus adjacent to the surgical site.
- ALOD is more frequently observed after spinal fusion (arthrodesis) than disc replacement (arthroplasty).
- Long-term (10-year) clinical outcomes associated with ALOD have not been previously investigated.
Purpose of the Study:
- To determine the clinical significance of ALOD on long-term functional outcomes after anterior cervical discectomy and fusion (ACDF) or Bryan cervical disc arthroplasty.
- To compare the incidence of ALOD between ACDF and arthroplasty groups at a 10-year follow-up.
Main Methods:
- A retrospective review of a prospective, randomized controlled trial comparing ACDF with Bryan cervical disc arthroplasty.
- Radiographic evaluation for ALOD at the cephalad-adjacent level in 40 patients at 10-year follow-up.
- Statistical analysis to compare ALOD rates and functional outcomes (NDI, VAS-arm, VAS-neck) between surgical groups and ALOD severity.
Main Results:
- Patients undergoing cervical arthrodesis with plate fixation showed a significantly higher rate of high-grade ALOD compared to cervical arthroplasty (68.2% vs. 11.1%, P=0.0003).
- No significant differences in functional outcomes (NDI, VAS-arm, VAS-neck) were observed between patients with high-grade versus low-grade ALOD at 10 years.
- ALOD was significantly more prevalent in the ACDF group than the arthroplasty group.
Conclusions:
- ALOD is a radiographic finding that does not appear to significantly alter long-term patient-reported functional outcomes.
- The choice between ACDF and arthroplasty may influence ALOD development, but not necessarily long-term functional results.
- Further research may explore the implications of ALOD beyond functional scores.
More Related Videos
Related Concept Videos
01:27Degenerative Disc Disease I: Introduction
Degenerative disc disease is a chronic condition in which intervertebral discs gradually lose structure and function. It is not infectious or autoimmune; rather, it results from age-related biochemical and mechanical changes, influenced by genetic, metabolic, and environmental factors.Structure and Function of DiscsThe spine contains 23 intervertebral discs that absorb load, distribute forces, maintain spacing, and allow flexibility. Each disc consists of a nucleus pulposus, a gel-like core...
01:23Degenerative Disc Disease ll: Pathophysiology
The symptoms of degenerative disc disease arise from a combination of mechanical compression, vascular compromise, and biochemical inflammation, which together disrupt nerve function and produce pain.Mechanical CompressionDisc degeneration reduces height and elasticity, predisposing to herniation of the nucleus pulposus, a major cause of radicular pain. Herniations may be protrusion (bulging with intact annulus), extrusion (nucleus extends beyond disc but remains connected), or sequestration...