Assessment of adjacent segment degeneration in and between patients treated with anterior or posterior cervical simple discectomy.
OBJECTIVE
The authors compared the incidence of radiologically documented and/or symptomatic adjacent segment degeneration in and between patients who underwent anterior or posterior single-level, simple discectomy.


METHODS
79 patients were clinically and radiologically examined for adjacent segment degeneration (ASD). The results were compared to evaluate which approach was predominant for adjacent segment disc degeneration.


RESULTS
ASD was found in 57 of a total of 79 patients. 24% of the patients demonstrated clinical and radiographic evidence and 48% of the patients demonstrated only radiographic evidence of ASD. Both anterior and posterior single level simple discectomy had similar rates for adjacent segment disease (p>0.05) . ASD was found to appear earlier in patients who had anterior cervical discectomy (4.78 vs 9.85 years, p:0.005). Symptomatic evidence of ASD was found to start earlier than radiological evidence of ASD (4.67 vs 7.63 years p:0.003). Radiographic evidence of adjacent segment degeneration was observed more commonly compared to symptomatic evidence of ASD (38 vs 19 patients p:0.002).


CONCLUSIONS
Although, radiographic and clinical evidence of ASD is inevitable for both simple cervical discectomy procedures, neither anterior nor posterior simple cervical discectomy is the predominant approach for causing ASD.
Acikbas
Sabri Cem
SC
Akdeniz University, School of Medicine, Department of Neurosurgery, Antalya, Turkey. scem@adkeniz.edu.tr
Ermol
Cenk
C
Akyuz
Mahmut
M
Tuncer
Recai
R
D000328:Adult; D000368:Aged; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D017586:Diskectomy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D055959:Intervertebral Disc Degeneration / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D007405:Intervertebral Disc Displacement / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D011859:Radiography; D013123:Spinal Fusion / Q000379:methods*; D013997:Time Factors