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Adjacent segment degeneration after single- and double-level cervical total disc replacement: a cohort with an over 12-year follow-up

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A Correction to this article was published on 08 January 2024

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Abstract

Purpose

To characterize the change of adjacent segment degeneration (ASD) after cervical total disc replacement (CTDR) with more than 12-year follow-up, and identify the risk factors for ASD.

Method

This process included 75 patients underwent CTDR from February 2004 to December 2012, with the follow-up of 151.9 ± 36.0 (m). The artificial disc included ProDisc-C, Prestige-LP and Mobi-C. ASD was followed up at 1 week, 6 months, 1 year, 2 years, 5 years, 10 years after CTDR and at the endpoint of June 2022. The radiographic measurements were cervical mobility, intervertebral disc height (IDH), cervical lordosis and balance status. The complications were implant migration, subsidence and heterotopic ossification (HO).

Results

Cervical mobility in adjacent segments, IDH and lordosis showed no statistical differences between ASD and NASD group. Balance status, subsidence and migration showed no relationship with ASD. Postoperative ASD increased at 6 m and especially between 6 m to 2y. There was no difference between the incidence of upper ASD and lower ASD all the time and few ASD-related reoperation. The majority of adjacent segments were C4/5 (33.6%) and C6/7 (34.2%), and ASD of C5/6 had the highest incidence (61.5%). Cox regression showed ASD was not related to the types of prosthesis or operated numbers. Generalized estimating equations (GEE) analysis showed severe HO had a higher (2.68 times) probability to suffer from ASD.

Conclusions

After over 12-year follow-up of CTDR, the occurrence of ASD and HO had temporal synchronization. ASD was not merely a natural progression but with the pathological process such as HO.

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Acknowledgements

We thank Houshan Lv who contributed towards the study by making substantial contributions to the design and the acquisition of data.

Funding

This work was supported by Clinical Medicine Plus X-Young Scholars Project Peking University, the Fundamental Research Funds for the Central Universities [Grant Number PKU2023LCXQ042], the Beijing Natural Science Foundation [Grant Number 7232182] Research and Development Fund of Peking University People’s Hospital [Grant Number RDL2022-52].

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Author notes

  1. The authors, Yan Liang, Yalong Qian and Weiwei Xia have been contributed equally to the publication of this article.

Authors and Affiliations

  1. Department of Spinal Surgery, Peking University People’s Hospital, Peking University, No. 11 Xizhimen South Street, Xicheng District, Beijing, 100044, People’s Republic of China

    Yan Liang, Yalong Qian, Weiwei Xia, Chen Guo, Zhenqi Zhu, Haiying Liu & Shuai Xu

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  1. Yan Liang
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Contributions

XS, QYL and LY were involved in the conceptualization; LY, XS and QYL contributed to the data curation; LY and XS contributed to the formal analysis; XS, QYL, XWW and GC were involved in the investigation; XS, QYL, LY and ZZQ contributed to the methodology; LY, ZZQ and LHY were involved in the project administration; XS, QYL, XWW and ZZQ contributed to the resources; XS and LY contributed to the software; LY was involved in the validation; XS, QYL and XWW contributed to the visualization; XS, QYL, GC and LY were involved in the writing and editing. All authors read and approved the final manuscript.

Ethics approval and consent to participate: The study has been approved by the ethics committee of our institution and all participants have signed the consent informs.

Consent for publication: Not applicable.

Competing interests: The authors declare that they have no competing interests.

Corresponding author

Correspondence to Shuai Xu.

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Liang, Y., Qian, Y., Xia, W. et al. Adjacent segment degeneration after single- and double-level cervical total disc replacement: a cohort with an over 12-year follow-up. Eur Spine J 33, 232–242 (2024). https://doi.org/10.1007/s00586-023-08018-3

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