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European Spine Journal
Published in: European Spine Journal 12/2015

01-12-2015 | Original Article

Correlation between cervical lordosis and adjacent segment pathology after anterior cervical spinal surgery

Authors: Soo Eon Lee, Tae-Ahn Jahng, Hyun Jib Kim

Published in: European Spine Journal | Issue 12/2015

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Abstract

Purpose

To evaluate the incidence and risk factors for adjacent segment pathology (ASP) after anterior cervical spinal surgery.

Methods

Fourteen patients (12 male, mean age 47.1 years) who underwent single-level cervical disk arthroplasty (CDA group) and 28 case-matched patients (24 male, mean age 53.6 years) who underwent single-level anterior cervical discectomy and fusion (ACDF group) were included. Presence of radiologic ASP (RASP) was based on observed changes in anterior osteophytes, disks, and calcification of the anterior longitudinal ligament on lateral radiographs.

Results

The mean follow-up period was 43.4 months in the CDA group and 44.6 months in the ACDF group. At final follow-up, ASP was observed in 5 (35.7 %) CDA patients and 16 (57.1 %) ACDF patients (p = 0.272). The interval between surgery and ASP development was 33.8 months in the CDA group and 16.3 months in the ACDF group (p = 0.046). The ASP risk factor analysis indicated postoperative cervical angle at C3–7 being more lordotic in non-ASP patients in both groups. Restoration of lordosis occurred in the CDA group regardless of the presence of ASP, but heterotopic ossification development was associated with the presence of ASP in the CDA group. And the CDA group had significantly greater clinical improvements than those in the ACDF group when ASP was present.

Conclusion

In both CDA and ACDF patients, RASP developed, but CDA was associated with a delay in ASP development. A good clinical outcome was expected in CDA group, even when ASP developed. Restoration of cervical lordosis was an important factor in anterior cervical spine surgery.
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Metadata
Title
Correlation between cervical lordosis and adjacent segment pathology after anterior cervical spinal surgery
Authors
Soo Eon Lee
Tae-Ahn Jahng
Hyun Jib Kim
Publication date
01-12-2015
Publisher
Springer Berlin Heidelberg
Published in
European Spine Journal / Issue 12/2015
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI
https://doi.org/10.1007/s00586-015-4132-6

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