The Comparison of Multi-level Fusion versus One-level Fusion to the Development of Adjacent Level Degeneration in Anterior Cervical Arthrodesis with PEEK Cage and Plate Augmentation for the Degenerative Cervical Spinal Disorders

Song, Kyung-Jin; Lee, Su-Kyung; Song, Jihun; Choi, Byeong-Yeol

doi:10.4055/jkoa.2009.44.6.613

Cited by 3 publications

(2 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Firstly, regarding the fixation area, adjacent-level failures occurred in patients who received fixation of ''O-T4'' or longer distance, which suggested that the long fusion might cause adjacent-level failures due to greater mechanical stress. In a similar way, Song et al [15,16] reported that fusion may increase mechanical stress at adjacent disc levels and lead to adjacent segment disease, and that multi-level fusion accelerated the severity of adjacent-level degeneration as compared to single-level fusion in degenerative cervical disease.…”

Section: Discussionmentioning

confidence: 88%

Adjacent-level failures after occipito-thoracic fusion for rheumatoid cervical disorders

Tanouchi¹,

Shimizu²,

Fueki³

et al. 2013

Eur Spine J

View full text Add to dashboard Cite

Introduction The natural history of cervical spine lesions in rheumatoid arthritis (RA) is variable. We have actively performed occipito-thoracic fusion for severe destructive rheumatoid cervical disorders and reported its clinical results and complications. In our previous study, the most frequent complication was the adjacent-level failures caused by the fragile spine. The objective of this study was to determine risk factors for adjacent-level failures after occipito-thoracic fusion. Materials and Methods Subjects were 35 RA patients (31 females and 4 males) who underwent occipito-thoracic fusion using RRS Loop Spinal System Ò (Robert Reid Inc. Tokyo, Japan), and the incidence and characteristics of adjacent-level failures were investigated. Furthermore, the adjacent-level failures were divided into two types according to their levels, fracture at the lowest level of the fusion area and that at the level inferior to the fusion area, and the characteristics of each type were evaluated. Results and Conclusion Nine (26 %) of 35 patients suffered adjacent-level failures (10 vertebral fractures). Adjacent-level failures occurred when the distance of fixation was ''O-T4'' or longer. The long fusion might cause adjacentlevel failures due to greater mechanical stress. Seven fractures occurred at the lowest level of the fusion area, and all of them were cured without symptoms by conservative treatment. Three fractures occurred at the level inferior to the fusion area, and one of them needed additional surgery due to sudden paraplegia resulting from collapse of the adjacent vertebra. After occipito-thoracic fusion, burst fractures at the level inferior to the fusion area might cause sudden paraplegia, and therefore a careful observation should be required for patients with these fractures.

show abstract

Section: Discussionmentioning

confidence: 88%

Adjacent-level failures after occipito-thoracic fusion for rheumatoid cervical disorders

Tanouchi¹,

Shimizu²,

Fueki³

et al. 2013

Eur Spine J

View full text Add to dashboard Cite

show abstract

“…Hilibrand et al [12] concluded that adjacent segment disease is more likely to be a product of the natural history of the disease based on the finding that adjacent segment disease occurred at a relatively constant rate, was more likely at C5/6 and C6/7, occurred in older patients, and was significantly less likely after multilevel fusion. Our previous study showed that multi-level fusion using a cage and plate augmentation procedure accelerated the severity of adjacent level degeneration as compared with single level fusion, but we found no correlation between the incidence of symptomatic adjacent level disease and numbers of fusion levels after anterior cervical arthrodesis in degenerative cervical diseases [19]. Scare reports have been issued on the natural history of adjacent segment disease without fusion in cases of degenerative cervical disease.…”

Section: Discussionmentioning

confidence: 99%

Adjacent segment degenerative disease: is it due to disease progression or a fusion-associated phenomenon? Comparison between segments adjacent to the fused and non-fused segments

et al. 2011

Self Cite

View full text Add to dashboard Cite

Introduction The purpose of this study was to determine whether fusion causes adjacent segment degeneration or whether degeneration is due to disease progression. Materials and methods Eighty-seven patients that had undergone single level anterior cervical decompression and fusions with at least 5 years of follow-up were enrolled in this retrospective study. Segments adjacent to fusion levels (above or below) were allocated to group A, and all others were allocated to group B. Radiographic evaluations of adjacent level changes included assessments of; disc degenerative changes, anterior ossification formation, and segmental instability. The developments of new clinical symptoms were also evaluated. Results In group A, adjacent segment degenerative change developed in 28 segments (16%) and two cases (2%) developed new clinical symptoms. In group B, adjacent segment degenerative change developed in 10 segments (3%), and two cases (0.7%) also developed new clinical symptoms. Additional operations were performed in one patient in each group. Conclusion Although, fusion per se can accelerate the severity of adjacent level degeneration, no significant difference was observed between adjacent and non-adjacent segments in terms of the incidence of symptomatic disease.The authors conclude that adjacent segment disease is more a result of the natural history of cervical spondylosis than the presence of fusion.

show abstract

Significance of Mal-alignment after Anterior Cervical Arthrodesis in Degenerative Cervical Spinal Disorders

Song

Lee

Park

et al. 2011

J Korean Orthop Assoc

View full text Add to dashboard Cite

The Comparison of Multi-level Fusion versus One-level Fusion to the Development of Adjacent Level Degeneration in Anterior Cervical Arthrodesis with PEEK Cage and Plate Augmentation for the Degenerative Cervical Spinal Disorders

Cited by 3 publications

References 18 publications

Adjacent-level failures after occipito-thoracic fusion for rheumatoid cervical disorders

Adjacent-level failures after occipito-thoracic fusion for rheumatoid cervical disorders

Adjacent segment degenerative disease: is it due to disease progression or a fusion-associated phenomenon? Comparison between segments adjacent to the fused and non-fused segments

Significance of Mal-alignment after Anterior Cervical Arthrodesis in Degenerative Cervical Spinal Disorders

Contact Info

Product

Resources

About