title: Prevalence of adjacent segment disease following cervical spine surgery: A PRISMA-compliant systematic review and meta-analysis.
abstract: Prevalence estimates of adjacent segment degeneration (ASD) following cervical spine surgery varied greatly in current studies. We conducted a systematic review and meta-analysis to summarize the point prevalence of ASD after cervical spine surgery.
  
  
  METHODS
  Comprehensive electronic searches of PubMed, Embase, Web of Knowledge, and Cochrane Library databases were conducted to identify any study published from initial state to January 2016. Those reporting the prevalence of ASD after cervical surgery were included. A random-effects model was used to estimate the prevalence of radiographic ASD, symptomatic ASD, and reoperation ASD. Univariate meta-regression analyses were conducted to explore the potential associations between prevalence and length of follow-up. All analyses were performed using R version 3.2.3 (R Foundation for Statistical Computing).
  
  
  RESULTS
  A total of 83 studies were included in the meta-analysis. The prevalence of radiographic ASD, symptomatic ASD, and reoperation ASD after cervical surgery was 28.28% (95% confidence interval [CI], 20.96-36.96), 13.34% (95% CI, 11.06-16.00), and 5.78% (95% CI, 4.99-6.69), respectively, in a general analysis. It was found 2.79%, 1.43%, and 0.24% additions per year of follow-up in the incidence of radiographic ASD, symptomatic ASD, and reoperation ASD, respectively.
  
  
  CONCLUSIONS
  This meta-analysis provides some details about the prevalence of radiographic ASD, symptomatic ASD, and reoperation ASD after cervical spine surgery. However, the results of this meta-analysis should be interpreted with caution because of the heterogeneity among the studies.
authors.affiliation: Department of Orthopedics, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, P.R. China.
authors.forename: Lingde
authors.initials: L
authors.lastname: Kong
authors.forename: Junming
authors.initials: J
authors.lastname: Cao
authors.forename: Linfeng
authors.initials: L
authors.lastname: Wang
authors.forename: Yong
authors.initials: Y
authors.lastname: Shen
mesh_terms: D002574:Cervical Vertebrae / Q000601:surgery*; D017586:Diskectomy / Q000009:adverse effects*; D006801:Humans; D011183:Postoperative Complications / Q000453:epidemiology*; D015995:Prevalence; D013122:Spinal Diseases / Q000453:epidemiology*; D013123:Spinal Fusion / Q000009:adverse effects*