Journal of Korean Neurosurgical Society

  • 제59권2호
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  • Pages.129-136
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  • 2016
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  • 2005-3711(pISSN)
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  • 1598-7876(eISSN)
대한신경외과학회 (The Korean Neurosurgical Society)
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Radiologic Findings and Risk Factors of Adjacent Segment Degeneration after Anterior Cervical Discectomy and Fusion : A Retrospective Matched Cohort Study with 3-Year Follow-Up Using MRI

  • Ahn, Sang-Soak (Department of Neurosurgery, Spine and Spinal Cord Institute, Gangnam Severance Spine Hospital, Yonsei University College of Medicine) ;
  • So, Wan-Soo (Department of Neurosurgery, 21 Century Hospital) ;
  • Ku, Min-Geun (Department of Neurosurgery, 21 Century Hospital) ;
  • Kim, Sang-Hyeon (Department of Radiology, Dong-A University Medical Center) ;
  • Kim, Dong-Won (Department of Radiology, Dong-A University Medical Center) ;
  • Lee, Byung-Hun (Department of Neurosurgery, The Armed Forces Capital Hospital)
  • 투고 : 2015.10.19
  • 심사 : 2016.01.01
  • 발행 : 2016.03.01
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초록

Objective : The purpose of this study was to figure out the radiologic findings and risk factors related to adjacent segment degeneration (ASD) after anterior cervical discectomy and fusion (ACDF) using 3-year follow-up radiography, computed tomography (CT), and magnetic resonance image (MRI). Methods : A retrospective matched comparative study was performed for 64 patients who underwent single-level ACDF with a cage and plate. Radiologic parameters, including upper segment range of motion (USROM), lower segment range of motion (LSROM), upper segment disc height (UDH), and lower segment disc height (LDH), clinical outcomes assessed with neck and arm visual analogue scale (VAS), and risk factors were analyzed. Results : Patients were categorized into the ASD (32 patients) and non-ASD (32 patients) group. The decrease of UDH was significantly greater in the ASD group at each follow-up visit. At 36 months postoperatively, the difference for USROM value from the preoperative one significantly increased in the ASD group than non-ASD group. Preoperative other segment degeneration was significantly associated with the increased incidence of ASD at 36 months. However, pain intensity for the neck and arm was not significantly different between groups at any post-operative follow-up visit. Conclusion : The main factor affecting ASD is preoperative other segment degeneration out of the adjacent segment. In addition, patients over the age of 50 are at higher risk of developing ASD. Although there was definite radiologic degeneration in the ASD group, no significant difference was observed between the ASD and non-ASD groups in terms of the incidence of symptomatic disease.

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참고문헌

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피인용 문헌

  1. In-Depth Analysis on Influencing Factors of Adjacent Segment Degeneration After Cervical Fusion vol.22, pp.None, 2016, https://doi.org/10.12659/msm.902179
  2. Symptomatic adjacent segment disease after single-lever anterior cervical discectomy and fusion : Incidence and risk factors vol.96, pp.47, 2017, https://doi.org/10.1097/md.0000000000008663
  3. Are Controversial Issues in Cervical Total Disc Replacement Resolved or Unresolved?: A Review of Literature and Recent Updates vol.12, pp.1, 2018, https://doi.org/10.4184/asj.2018.12.1.178
  4. Comparison of radiological outcomes and complications between single-level and multilevel anterior cervical discectomy and fusion (ACDF) by using a polyetheretherketone (PEEK) cage–plate fusion vol.98, pp.5, 2016, https://doi.org/10.1097/md.0000000000014277
  5. Comparison of the long-term outcomes of total arthroplasty and anterior spinal fusion in the treatment of cervical degenerative disc disease: a metaanalysis vol.83, pp.6, 2016, https://doi.org/10.17116/neiro201983061100
  6. Is Adjacent Segment Disease More Frequent in Proximal Levels in Comparison with Distal Levels? Based on Radiological Data of at Least 2 Years Follow Up with More than 2 Level Thoracolumbar Fusions vol.62, pp.5, 2019, https://doi.org/10.3340/jkns.2019.0144