title: Adjacent segment pathology following anterior decompression and fusion using cage and plate for the treatment of degenerative cervical spinal diseases.
abstract: METHODS
  Retrospective study.
  
  
  OBJECTIVE
  To analyze the incidence and prevalence of clinical adjacent segment pathology (CASP) following anterior decompression and fusion with cage and plate augmentation for degenerative cervical diseases.
  
  
  BACKGROUND
  No long-term data on the use of cage and plate augmentation have been reported.
  
  
  METHODS
  The study population consisted of 231 patients who underwent anterior cervical discectomy and fusion (ACDF) with cage and plate for degenerative cervical spinal disease. The incidence and prevalence of CASP was determined by using the Kaplan-Meier survival analysis. To analyze the factors that influence CASP, data on preoperative and postoperative sagittal alignment, spinal canal diameter, the distance between the plate and adjacent disc, extent of fusion level, and the presence or absence of adjacent segment degenerative changes by imaging studies were evaluated.
  
  
  RESULTS
  CASP occurred in 15 of the cases, of which 9 required additional surgery. At 8-year follow-up, the average yearly incidence was 1.1%. The rate of disease-free survival based on Kaplan-Meier survival analysis was 93.6% at 5 years and 90.2% at 8 years. No statistically significant differences in CASP incidence based on radiological analysis were observed. Significantly high incidence of CASP was observed in the presence of increased adjacent segment degenerative changes (p<0.001).
  
  
  CONCLUSIONS
  ACDF with cage and plate for the treatment of degenerative cervical disease is associated with a lower incidence in CSAP by 1.1% per year, and the extent of preoperative adjacent segment degenerative changes has been shown as a risk factor for CASP.
authors.affiliation: Department of Orthopedic Surgery, Chonbuk National University Hospital, Chungbuk National University College of Medicine, Jeonju, Korea.
authors.forename: Kyung-Jin
authors.initials: KJ
authors.lastname: Song
authors.affiliation: Department of Orthopedic Surgery, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea.
authors.forename: Byung-Wan
authors.initials: BW
authors.lastname: Choi
authors.affiliation: Department of Orthopedic Surgery, Chonbuk National University Hospital, Chungbuk National University College of Medicine, Jeonju, Korea.
authors.forename: Jong-Kil
authors.initials: JK
authors.lastname: Kim
keywords: Adjacent segment pathology; Anterior cervical discectomy and fusion; Cage and plate; Degenerative cervical spine disease