Factors Affecting the Incidence of Symptomatic Adjacent-Level Disease in Cervical Spine After Total Disc Arthroplasty

Nunley, Pierce D.; Jawahar, Ajay; Kerr, Eubulus J.; Gordon, Charles J.; Cavanaugh, David A.; Birdsong, Elisa M.; Stocks, Marolyn; Danielson, Guy O.

doi:10.1097/brs.0b013e31822174b3

Cited by 126 publications

(72 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Recently, there have been several trials to assess ASD with MRI, and usability of MRI to assess ASD has been reported. Matumoto et al [27][28][29][30] reported 40-60 % degenerative change in adjacent disc after ACDF using MRI, and other study by CT also reported that asymptomatic ASD was detected as 50 %, and this result is very similar with our results. There has been no comparative study between ACDF and arthroplasty with MRI.…”

Section: Discussionsupporting

confidence: 91%

“…In comparative studies between ACDF and arthroplasty, they reported a lower rate of ASD because of preservation of neck motion [11,15,26]. However, these studies followed only X-ray or CT and lacked long-term results [1,[7][8][9][10][11], and other studies insisted no difference in ASD rate between ACDF and arthroplasty [12,27]. Even till now, we do not know the related factors, incidence and prevalence of ASD after ACDF and arthroplasty.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

What are the associative factors of adjacent segment degeneration after anterior cervical spine surgery? Comparative study between anterior cervical fusion and arthroplasty with 5-year follow-up MRI and CT

et al. 2012

View full text Add to dashboard Cite

Purpose It is well known that arthrodesis is associated with adjacent segment degeneration (ASD). However, previous studies were performed with simple radiography or CT. MRI is most sensitive in assessing the degenerative change of a disc, and this is the first study about ASD by radiography, CT and MRI. We sought to factors related to ASD at cervical spine by an MRI and CT, after anterior cervical spine surgery. Materials and methods This is a retrospective crosssectional study of cervical disc herniation. Patients of cervical disc herniation with only radiculopathy were treated with either arthroplasty (22 patients) or ACDF with cage alone (21 patients). These patients were required to undergo MRI, CT and radiography preoperatively, as well as radiography follow-up for 3 months and 1 year, and we conducted a cross-sectional study by MRI, CT and radiography including clinical evaluations 5 years after. Clinical outcomes were assessed using VAS and NDI. The fusion rate and ASD rate, and radiologic parameters (cervical lordosis, operated segmental height, C2-7 ROM, operated segmental ROM, upper segmental ROM and lower segmental ROM) were measured. Results The study groups were demographically similar, and substantial improvements in VAS (for arm) and NDI (for neck) scores were noted, and there were no significant differences between groups. Fusion rates were 95.2 % in the fusion group and 4.5 % in the arthroplasty group. ASD rates of the fusion and arthroplasty groups were 42.9 and 50 %, respectively. Among the radiologic parameters, operated segmental height and operated segmental ROM significantly decreased, while the upper segmental ROM significantly increased in the fusion group. In a comparative study between patients with ASD and without ASD, the clinical results were found to be similar, although preexisting ASD and other segment degeneration were significantly higher in the ASD group. C2-7 ROM was significantly decreased in ASD group, and other radiologic parameters have no significant differences between groups. Conclusion The ASD rate of 46.5 % after ACDF or arthroplasty, and arthroplasty did not significantly lower the rate of ASD. ASD occurred in patients who had preexisting ASD and in patients who also had other segment degeneration. ASD may be associated with a natural history of cervical spondylosis rather than arthrodesis.

show abstract

Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

What are the associative factors of adjacent segment degeneration after anterior cervical spine surgery? Comparative study between anterior cervical fusion and arthroplasty with 5-year follow-up MRI and CT

et al. 2012

View full text Add to dashboard Cite

show abstract

“…6,17,25,27,32 One randomized controlled trial did find a lower rate of radiographic adjacentlevel pathology in the CDR group. 9 Long-term studies are necessary to further elucidate whether motion-sparing surgery decreases the rate of clinical adjacent-segment pathology.…”

Section: Discussionmentioning

confidence: 99%

Health state utility of patients with single-level cervical degenerative disc disease: comparison of anterior cervical discectomy and fusion with cervical disc arthroplasty

Qureshi

Goz

McAnany

et al. 2014

SPI

View full text Add to dashboard Cite

Object Cost-effectiveness analysis (CEA) of medical interventions has become increasingly relevant to the discussion of optimization of care. The use of utility scales in CEA permits a quantitative assessment of effectiveness of a given intervention. There are no published utility values for degenerative disc disease (DDD) of the cervical spine, anterior cervical discectomy and fusion (ACDF), or cervical disc replacement (CDR). The purpose of this study was to define health utility values for those health states. Methods The 36-Item Short Form Health Survey data from the ProDisc-C investigational device exemption study were obtained for single-level DDD at baseline and 24 months postoperatively after ACDF or CDR procedures. Patients in the original study were randomized to either ACDF or CDR. Utilizing a commercially available Short Form–6 dimensions program, utility scores were calculated for each health state using a set of parametric preference weights obtained from a sample of the general population using the recognized valuation technique of standard gamble. Results The baseline health state utility (HSU) value for a patient with single-level DDD was 0.54 in both the ACDF and CDR groups. Postoperative changes in HSU values were seen in both intervention groups at 24 months. Cervical disc replacement had a HSU value of 0.72. Anterior cervical discectomy and fusion was found to have a postoperative utility state of 0.71. No statistically significant difference was found in the HSU for ACDF and CDR at 24 months of follow-up. Conclusions This study represents the first calculated HSU value for a patient with single-level cervical DDD. Additionally, 2 common treatment interventions for this disease state were assessed. Both treatments were found to have significant impact on the HSU values. These values are integral to future CEA of ACDF and CDR.

show abstract

“…Although adjacent intervertebral disc degeneration is not typically listed among the ACDF complications, it is well documented that anterior cervical spine surgery with fusion significantly alter the regional biomechanics, increase the load to the adjacent intervertebral discs, and introduce stress and instability to them (52)(53)(54)(55)(56)(57)(58)(59)(60)(61)(62). However, Hilibrand and Robbins (63) raised the question of whether this adjacent segment degeneration was the result of the previous surgical intervention or may just reflect the underlying natural history of the cervical degenerative process.…”

Section: Adjacent Segment Disc Diseasementioning

confidence: 99%

Anterior cervical spine surgery-associated complications in a retrospective case-control study

Τάσιου¹,

Giannis²,

Brotis³

et al. 2017

J. Spine Surg.

102

107

View full text Add to dashboard Cite

Anterior cervical spine procedures have been associated with satisfactory outcomes. However, the occurrence of troublesome complications, although uncommon, needs to be taken into consideration.The purpose of our study was to assess the actual incidence of anterior cervical spine procedure-associated complications and identify any predisposing factors. A total of 114 patients undergoing anterior cervical procedures over a 6-year period were included in our retrospective, case-control study. The diagnosis was cervical radiculopathy, and/or myelopathy due to degenerative disc disease, cervical spondylosis, or traumatic cervical spine injury. All our participants underwent surgical treatment, and complications were recorded.The most commonly performed procedure (79%) was anterior cervical discectomy and fusion (ACDF).Fourteen patients (12.3%) underwent anterior cervical corpectomy and interbody fusion, seven (6.1%) ACDF with plating, two (1.7%) odontoid screw fixation, and one anterior removal of osteophytes for severe Forestier's disease. Mean follow-up time was 42.5 months (range, 6-78 months). The overall complication rate was 13.2%. Specifically, we encountered adjacent intervertebral disc degeneration in 2.7% of our cases, dysphagia in 1.7%, postoperative soft tissue swelling and hematoma in 1.7%, and dural penetration in 1.7%. Additionally, esophageal perforation was observed in 0.9%, aggravation of preexisting myelopathy in 0.9%, symptomatic recurrent laryngeal nerve palsy in 0.9%, mechanical failure in 0.9%, and superficial wound infection in 0.9%. In the vast majority anterior cervical spine surgery-associated complications are minor, requiring no further intervention. Awareness, early recognition, and appropriate management, are of paramount importance for improving the patients' overall functional outcome.

show abstract

Factors Affecting the Incidence of Symptomatic Adjacent-Level Disease in Cervical Spine After Total Disc Arthroplasty

Abstract: The risk of developing adjacent segment degeneration was equivalent at median 38 months after both ACDF and TDA procedures in cervical DDD. Osteopenia and concurrent lumbar DDD significantly increase the risk of ALD.

Cited by 126 publications

References 20 publications

What are the associative factors of adjacent segment degeneration after anterior cervical spine surgery? Comparative study between anterior cervical fusion and arthroplasty with 5-year follow-up MRI and CT

What are the associative factors of adjacent segment degeneration after anterior cervical spine surgery? Comparative study between anterior cervical fusion and arthroplasty with 5-year follow-up MRI and CT

Health state utility of patients with single-level cervical degenerative disc disease: comparison of anterior cervical discectomy and fusion with cervical disc arthroplasty

Anterior cervical spine surgery-associated complications in a retrospective case-control study

Contact Info

Product

Resources

About