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Adjacent segment pathology: natural history or effect of anterior cervical discectomy and fusion? A 10-year follow-up radiological multicenter study using an evaluation scale of the ageing spine

  • Alessandro PesceEmail author
  • Venceslao Wierzbicki
  • Emanuele Piccione
  • Alessandro Frati
  • Antonino Raco
  • Riccardo Caruso
Original Article • SPINE - CERVICAL

Abstract

Purpose

Aim of this study is to compare late degenerative MRI changes in a subset of patients operated on with ACDF to a second subset of patients presenting indication to ACDF but never operated on.

Methods

Patients from both subgroups received surgical indication according to the same criteria. Both subgroups underwent a cervical spine MRI in 2004–2005 and 10 years later in 2015. These MRI scans were retrospectively evaluated with a cervical spine ageing scale.

Results

Comparing the two subset of patients both suffering from clinically relevant single-level disease returns no statistically significant difference in the degenerative condition of posterior ligaments, presence of degenerative spondylolisthesis, foraminal stenosis, diameter of the spinal canal, Modic alteration, and intervertebral discs degeneration at 10-year follow-up.

Conclusions

The adjacent segment degeneration represents, in the present cohort, a result of the natural history of cervical spondylosis rather than a consequence of fusion.

Keywords

Cervical spondylosis Ageing spine ACDF Adjacent segment pathology Cervical arthroplasty MRI 

Abbreviations

ACDF

Anterior cervical discectomy and fusion

CS

Cervical spine

C-SDD

Cervical spine degenerative disease

C-DDD

Cervical degenerative disc disease

ASD

Adjacent segment degeneration

FSU

Functional spinal unit

MRI

Magnetic resonance imaging

Notes

Compliance with ethical standards

Conflict of interest

The authors certify that they have no conflict of interest; they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge, or beliefs) in the subject matter or materials discussed in this manuscript. The authors confirm their adherence to ethical standards and have no financial disclosures that would be a potential conflict of interest with this publication.

Research guidelines

Online Enhancing the Quality and Transparency Of health Research check was performed and returned STROBE. All the subheadings included in each paragraph are coherent with STROBE research protocol. This work reaches the STROBE research guidelines required standards.

Research involving human participants and/or animals and informed consent

This is a research project involving human subjects. It is perfectly consistent, in any of its aspect, with WMA Helsinki Declaration of Human Rights. All the patients of the surgical subgroup expressed consent to the surgical procedure after appropriate information. All the patients from both subgroups gave informed explicit consent to undergo the follow-up MRI; before performing the MRI they were elucidated about the purpose of the study.

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Copyright information

© Springer-Verlag France 2017

Authors and Affiliations

  1. 1.Neurosurgery Division, NESMOS Department, A.O. “Sant’Andrea”Sapienza University of RomeRomeItaly
  2. 2.Neurosurgery Division, Dipartimento Scienze Neurosensoriali, Rome Army Hospital “Celio”Sapienza University of RomeRomeItaly
  3. 3.Radiology Division, Dipartimento Scienze Scienze Radiologiche, Rome Army Hospital “Celio”Sapienza University of RomeRomeItaly
  4. 4.Neurosurgery Division, IRCCS “Neuromed”Sapienza University of RomePozzilliItaly

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