科研之友
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摘要
Background: Anterior cervical fusion is widely used to treat spinal injuries. Radiological evidence of discabnormalities may develop on either side of the fused segment, raising concern about the potential forinducing adjacent-segment disease. Here, we report the long-term clinical, functional, and radiologicaloutcomes after anterior cervical fusion. Hypothesis: Anterior cervical fusion influences the development of adjacent-segment disease. Materials and methods: In a retrospective study, 15 patients aged 17 to 50 years were re-evaluated morethan 5 years after anterior spinal fusion to treat post-traumatic cervical-spine instability. We used the Neck Disability Index (NDI) to assess function. Static and dynamic radiographs of the cervical spine were obtained. Results: NDI values indicated good clinical and functional outcomes, and fusion was achieved consistently. Adjacent-segment disease was a consistent finding at last followup but induced no neurological manifestations. Complete fusion of a level adjacent to the treated level was noted in 2 patients. Revision surgery for adjacent-segment disease was not required in any patient. Conclusion: The causative factors of adjacent-segment disease are controversial. Disc degeneration is a normal manifestation of the ageing process. Nevertheless, disc disease is more prevalent at levels adjacent to interbody fusion than in the normal population, suggesting accelerated disc degeneration due to increased loading of the adjacent levels. Furthermore, lesions that are missed during the preoperative work-up may play a role, as the available investigations do not always have high negativepredictive values. Level of evidence: Level IV, retrospective study.
- 出版日期2014-6
