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European Spine Journal

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Open Access 01-08-2015 | Original Article

Cervical canal stenosis and adjacent segment degeneration after anterior cervical arthrodesis

Authors: Jing Tao Zhang, Jun Ming Cao, Fan Tao Meng, Yong Shen

Published in: European Spine Journal | Issue 8/2015

Abstract

Purpose

Adjacent segment degeneration (ASD) is known to occur after anterior cervical arthrodesis. However, it is not known whether cervical canal stenosis enhances the risk of ASD. The purpose of this study was to explore whether congenital stenosis could be used as a predictor of ASD after anterior cervical decompression and fusion (ACDF).

Methods

We enrolled 141 patients who had undergone ACDF for cervical myelopathy and/or radiculopathy, and had at least 6 years of follow-up. In standard radiographs of cervical spine in lateral view, bony congenital stenosis was evaluated and all patients were divided into two groups: stenosis (n = 63) and non-stenosis (n = 78). Radiographic ASD was assessed according to the criteria of Kellgren and Lawrence and correlated with symptomatic ASD. Clinical and radiological parameters were compared between the groups. The primary outcome was the rate of radiographic ASD after initial ACDF. The incidence of symptomatic ASD was assessed by Kaplan–Meier method.

Results

Radiographic ASD and symptomatic ASD developed in 46.8 % and 18.4 % of all patients, respectively. There was a significant association between congenital stenosis and radiographic ASD. The area under the receiver operating characteristic curve of preoperative anteroposterior (AP) diameter of cervical canal for predicting radiographic ASD was 0.756. 13.0 mm was the cutoff value of preoperative AP diameter of cervical canal predicting radiographic ASD. Kaplan–Meier analysis predicted a disease-free survival rate of symptomatic ASD in 97.2 % of patients at 5 years and 78.0 % at 10 years after ACDF. There was no significant difference in survival rates of the adjacent segment between the two groups via log-rank analysis (P = 0.102).

Conclusion

Congenital stenosis can increase the rate of radiographic ASD after initial ACDF. The cutoff value of 13.0 mm for preoperative AP diameter of cervical canal had the highest validity for predicting radiographic ASD.

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Title: Cervical canal stenosis and adjacent segment degeneration after anterior cervical arthrodesis
Authors: Jing Tao Zhang
Jun Ming Cao
Fan Tao Meng
Yong Shen
Publication date: 01-08-2015
Publisher: Springer Berlin Heidelberg
Published in: European Spine Journal / Issue 8/2015
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI: https://doi.org/10.1007/s00586-015-3975-1

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Cervical canal stenosis and adjacent segment degeneration after anterior cervical arthrodesis

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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