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Adjacent segment degenerative disease: is it due to disease progression or a fusion-associated phenomenon? Comparison between segments adjacent to the fused and non-fused segments

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Abstract

Introduction

The purpose of this study was to determine whether fusion causes adjacent segment degeneration or whether degeneration is due to disease progression.

Materials and methods

Eighty-seven patients that had undergone single level anterior cervical decompression and fusions with at least 5 years of follow-up were enrolled in this retrospective study. Segments adjacent to fusion levels (above or below) were allocated to group A, and all others were allocated to group B. Radiographic evaluations of adjacent level changes included assessments of; disc degenerative changes, anterior ossification formation, and segmental instability. The developments of new clinical symptoms were also evaluated.

Results

In group A, adjacent segment degenerative change developed in 28 segments (16%) and two cases (2%) developed new clinical symptoms. In group B, adjacent segment degenerative change developed in 10 segments (3%), and two cases (0.7%) also developed new clinical symptoms. Additional operations were performed in one patient in each group.

Conclusion

Although, fusion per se can accelerate the severity of adjacent level degeneration, no significant difference was observed between adjacent and non-adjacent segments in terms of the incidence of symptomatic disease. The authors conclude that adjacent segment disease is more a result of the natural history of cervical spondylosis than the presence of fusion.

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Authors and Affiliations

  1. Department of Orthopedic Surgery, School of Medicine, Research Institute of Clinical Medicine, Chonbuk National University Hospital, Jeonju, Korea

    Kyung-Jin Song & Kwang-Bok Lee

  2. Department of Orthopedic Surgery, Spine Center, Inje University, Haeundae Paik Hospital, 1435, Jwa-dong, Haeundae-gu, Busan, 612-030, Republic of Korea

    Byung-Wan Choi, Taek-Soo Jeon & Han Chang

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  1. Kyung-Jin Song
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  2. Byung-Wan Choi
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  3. Taek-Soo Jeon
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  4. Kwang-Bok Lee
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  5. Han Chang
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Correspondence to Byung-Wan Choi.

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Song, KJ., Choi, BW., Jeon, TS. et al. Adjacent segment degenerative disease: is it due to disease progression or a fusion-associated phenomenon? Comparison between segments adjacent to the fused and non-fused segments. Eur Spine J 20, 1940–1945 (2011). https://doi.org/10.1007/s00586-011-1864-9

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  • DOI: https://doi.org/10.1007/s00586-011-1864-9

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