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Adjacent segment mobility after ACDF considering fusion status at the implant insertion site
Bartosz Godlewski1, Adam Bebenek2, Maciej Dominiak2
1Department of Orthopaedics and Traumatology, with Spinal Surgery Ward, Scanmed - St. Raphael Hospital in Cracow, ul. Adama Bochenka 12, 30-693, Cracow, Poland. bartoszgodlewski@wp.pl.
Summary
Adjacent segment mobility increased after anterior cervical discectomy and fusion (ACDF) surgery. This compensatory hypermobility was greater with complete fusion compared to pseudoarthrosis, impacting spinal fusion outcomes.
Area of Science:
- Spinal surgery
- Orthopedics
- Biomechanics
Background:
- Adjacent segment disease is a concern after spinal fusion.
- Understanding mobility changes post-ACDF is crucial for patient outcomes.
Purpose of the Study:
- Analyze mobility changes in segments adjacent to the operated site.
- Investigate the relationship between fusion degree and adjacent segment mobility.
Main Methods:
- 170 disc spaces in 104 patients underwent surgery.
- Segmental mobility measured pre-surgery and 12 months post-surgery.
- Cervical spine radiographs and CT scans assessed fusion status.
Main Results:
- Significant mobility increase (1.7 mm) in segments below the operative site.
- Complete fusion (71.1%) vs. partial fusion (29.9%).
- Greater mobility in segments below the operative site with complete fusion than with pseudoarthrosis.
Conclusions:
- ACDF surgery significantly increases mobility in the adjacent segment below the implant.
- Complete fusion leads to greater compensatory hypermobility than pseudoarthrosis.
- Implant subsidence did not affect adjacent segment mobility.
