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Three-dimensional kinematic analysis of the cervical spine after anterior cervical decompression and fusion at an adjacent level: a preliminary report

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Abstract

Purpose

Development of adjacent segment degeneration following anterior cervical decompression and fusion (ACDF) is still controversial, as adjacent-level kinematics is poorly understood. This study reports preliminary data from a high-accuracy 3D analysis technique developed for in vivo cervical kinematics.

Methods

From nine cervical spondylosis patients, four underwent single-level ACDF, and five underwent two-level ACDF using cylindrical titanium cage implant(s). Pre- and post-surgical CT scans were taken in flexion, neutral and extended positions, allowing us to compute segmental ranges of motion for rotation and translation, and 3D disc-height distributions. Differences in segmental motions and disc-height between fused and adjacent levels were analyzed with a Wilcoxon signed-rank test. Results are presented as mean ± SEM.

Results

The flexion/extension angular-ROM at the fusion level decreased after surgery (7.46 ± 1.17° vs. 3.14 ± 0.56°, p < 0.003). The flexion/extension angular-ROM at one caudal adjacent level to the fusion level (3.97 ± 1.29°) tended to be greater post-operatively (6.11 ± 1.44°, p = 0.074). Translation in the anterior-posterior direction during flexion/extension at the fusion level decreased after surgery (1.22 ± 0.20 mm vs. 0.32 ± 0.11 mm, p < 0.01). No differences were found in adjacent-level disc heights between both study time-points.

Conclusions

This study showed increased segmental motion in flexion/extension angular-ROM at one level adjacent to ACDF. However, increases in the rotational angular-ROM were not statistically significant when cranial/caudal adjacent levels were analyzed separately. This preliminary study highlighted the capabilities of a 3D-kinematic analysis method to detect subtle changes in kinematics and disc height at the adjacent levels to ACDF. Thus, reliable evidence related to ACDF’s influence on adjacent-level cervical kinematics can be collected.

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Conflict of interest

The authors report no conflict of interest concerning the materials or methods used in this study or the findings specified in this paper.

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Authors and Affiliations

  1. Center for Spine and Spinal Cord Disorders, Southern Tohoku General Hospital, 1-2-5 Satonomori, Iwanuma, Miyagi, 989-2483, Japan

    Sadayoshi Watanabe, Yoshitaka Hirano & Junichi Mizuno

  2. Spine Biomechanics Lab, Department of Orthopaedic Surgery, Rush University Medical Center, 1611 W Harrison Street, Suite 201 Orthopaedic Building, Chicago, IL, 60612, USA

    Sadayoshi Watanabe, Nozomu Inoue & Alejandro A. Espinoza Orías

  3. Department of Biomedical Engineering, Doshisha University, Kyotanabe, Kyoto, 610-0321, Japan

    Nozomu Inoue, Tomonori Yamaguchi & Shintaro Nishida

  4. Department of Neurosurgery, Fujita Health University, Toyoake, Aichi, 470-1192, Japan

    Yuichi Hirose

Authors
  1. Sadayoshi Watanabe
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  2. Nozomu Inoue
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  3. Tomonori Yamaguchi
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  4. Yoshitaka Hirano
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  5. Alejandro A. Espinoza Orías
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  6. Shintaro Nishida
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  7. Yuichi Hirose
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  8. Junichi Mizuno
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Corresponding author

Correspondence to Junichi Mizuno.

Additional information

Abstracts based on this study have been presented at the 38th Annual Meeting of the Cervical Spine Research Society, held on December 2–4, 2010 in Charlotte, North Carolina and the 2011 Annual Meeting of the Orthopaedic Research Society, January 13–16, 2011, Long Beach, California.

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Watanabe, S., Inoue, N., Yamaguchi, T. et al. Three-dimensional kinematic analysis of the cervical spine after anterior cervical decompression and fusion at an adjacent level: a preliminary report. Eur Spine J 21, 946–955 (2012). https://doi.org/10.1007/s00586-011-2090-1

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  • DOI: https://doi.org/10.1007/s00586-011-2090-1

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