Degenerative arthritis of the adjacent spinal joints following anterior cervical spinal fusion: clinicoradiologic and statistical correlations.
On the premise that cervical intersomatic spinal fusion in the treatment of traumatic or spondylolytic myelopathy and post-traumatic instability provokes degenerative arthritis due to functional overloading of the spaces adjacent to the fusion, 37 patients (average age 57, range 25-80) who had undergone spinal fusion by Cloward's technique were subjected to radiographic study and clinical evaluation. The average follow-up was 11.5 years (range 7-16 years). In comparison with a control group of the same age who had not undergone this operation, these patients' C3-C4 and C6-C7 spaces (adjacent to the most commonly fused vertebrae) were smaller by 16.7% and 15.9%, respectively. In spite of the worsening of the radiographic situation, from a clinical standpoint there was a significant improvement in the symptomatology of 86.5% of the patients. Thus the degenerative arthritis is both less evident and, as far as the long-term clinical outcome is concerned, less influential than could be expected. This finding is confirmed by the lack of statistical correlation between the clinical results and the radiographic evidence.
Cherubino
P
P
Istituto di Clinica Ortopedica e Traumatologica dell'Università, IRCCS Policlinico S. Matteo, Pavia.
Benazzo
F
F
Borromeo
U
U
Perle
S
S
D000328:Adult; D000368:Aged; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology; D013123:Spinal Fusion; D013166:Spondylitis / Q000000981:diagnostic imaging / Q000209:etiology*; D013997:Time Factors; D014057:Tomography, X-Ray Computed