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Updated: Oct 6, 2025
Cone Beam Intraoperative Computed Tomography-based Image Guidance for Minimally Invasive Transforaminal Interbody Fusion
Published on: August 6, 2019
Are Congenital Cervical Block Vertebrae a Risk Factor for Adjacent Segment Disease? A Retrospective Cross-Sectional
Cornelius Jung1,2, Patrick Asbach1,2, Stefan M Niehues1
1Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, Department of Radiology, Hindenburgdamm 30, 12203 Berlin, Germany.
Abstract:
Adjacent segment disease (ASDI) is a well-described complication of spinal fusion surgery that may ultimately lead to spinal stenosis and repeated surgical intervention. Although congenital block vertebrae also present with degenerative changes in the adjacent segments, this has not yet been systematically investigated. The aim of this study was to assess the presence and degree of ASDI in congenital cervical block vertebrae.
Methods:
A total of 51 patients with congenital vertebral fusion in one cervical segment were analysed in this IRB-approved retrospective cross-sectional study using available CT/MR imaging. Exclusion criteria were prior spinal surgery and the presence of additional hereditary abnormalities. We assessed the severity of degenerative changes using a sum score. The sum score for adjacent and non-adjacent segments was then divided by the highest possible degeneration score, which resulted in a ratio of severity for adjacent and remaining segments (ranging from 0 to 1).
Results:
Overall, 35 of 51 patients (68.6%) showed evidence of ASDI, and 34 of 51 patients (66.7%) also showed degenerative changes in the remaining segments. The severity score was significantly higher (p = 0.025) in the segments adjacent to the congenital block vertebrae (mean value 0.307) compared to the non-adjacent segments (mean value 0.188).
Conclusions:
Our results suggest that ASDI is also caused by congenital block vertebrae of the cervical spine.
