Published online Dec 21, 2009.
https://doi.org/10.4055/jkoa.2009.44.6.613
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
Abstract
Purpose
The purpose of this study was to analyze the effect of multi-level fusion in the development of adjacent level degeneration (ALD) in anterior cervical arthrodesis, as a treatment for degenerative cervical disease.
Materials and Methods
Retrospectively, we analyzed 127 patients who underwent arthrodesis with PEEK cage and plate construction for the treatment of degenerative cervical disease. The mean patient age was 54.4±10.6 years and the average follow-up period was 48.5±8.5 months. Group A composed of 55 patients who underwent one level fusion and group B composed of 72 patients who underwent two or three level fusion. We evaluated and compared the severity of ALD, such as the stage of osteophyte formation, the grade of ALD, and the incidence of ALD according to 4 grading system.
Results
The stage of osteophyte formation was 1.62±0.85 points in group A and 2.43±1.14 points in group B (p=0.02). The grade of ADL was 1.71±0.94 points in group A and 2.38±1.11 points in group B (p=0.01). The incidence of symptomatic ALD (radiculopathy and/or myelopathy) was 3.6% (2/55 cases) in group A and 4.2% (3/77 cases) in group B (p>0.05).
Conclusion
Multi-level fusion can accelerate the severity of adjacent level degeneration as compared with one level fusion, but there was no correlation in the incidence of symptomatic adjacent level degeneration to the fusion level number after anterior cervical arthrodesis for degenerative cervical diseases.
Fig. 1
Histogram demonstrate the bony spur grading of adjacent segment in two group, multi-level arthrodesis leads to aggravation bony spur formation than one-level arthrodesis.
Fig. 2
Histogram demonstrate adjacent segmental degeneration according to disc space, multi-level arthrodesis accelate degeneration of adjacent segment.
Table 1
The Data of Patients
Table 2
Radiographic Grading of Degenerative Changes at Adjacent Level
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