title: In-Depth Analysis on Influencing Factors of Adjacent Segment Degeneration After Cervical Fusion.
abstract: BACKGROUND To explore the related influencing factors of adjacent segment degeneration (ASD) after cervical discectomy and fusion (ACDF). MATERIAL AND METHODS A retrospective analysis of 263 patients who underwent ACDF was carried out. Cervical x-ray and magnetic resonance imaging (MRI) were required before operation, after operation, and at the last follow-up. General information and some radiographic parameters of all patients were measured and recorded. According to the imaging data, patients were put into one of two groups: non-ASD group and ASD group. The differences between the two groups were compared by t-test and χ²-test, and the related influencing factors of ASD were analyzed by logistic regression. RESULTS In all, 138 patients had imaging ASD. Comparing the age, the postoperative cervical arc chord distance (po-CACD), and the plate to disc distance (PDD) of the two groups, differences were statistically significant (p<0.05). The gender, the fusion segment number, the pre-CACD, the pre-and-po CACD, the preoperative cervical spinal canal ratio, and the upper and lower disc height (DH) showed no statistical difference between the two groups (p>0.05). The results of logistic regression analysis showed that there were significant correlations in the following characteristics: age, postoperative po-CACD, and the PDD (p<0.05). Of all these characteristics, the correlation of age was the highest (R=1.820). CONCLUSIONS Age, po-CACD, and PDD were risk factors for ASD after ACDF. The older the operation age, the worse the recovery was of postoperative physiological curvature of cervical spine, and a PDD < 5 mm was more likely to lead to ASD.
authors.affiliation: Department of Orthopaedics, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China (mainland).|Graduate School, Guangxi Medical University, Nanning, Guangxi, China (mainland).
authors.forename: Chaojie
authors.initials: C
authors.lastname: Yu
authors.affiliation: Department of Orthopaedics, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China (mainland).
authors.forename: Xiaoping
authors.initials: X
authors.lastname: Mu
authors.affiliation: Department of Orthopaedics, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China (mainland).
authors.forename: Jianxun
authors.initials: J
authors.lastname: Wei
authors.affiliation: Department of Orthopaedics, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China (mainland).
authors.forename: Ye
authors.initials: Y
authors.lastname: Chu
authors.affiliation: Department of Orthopaedics, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China (mainland).
authors.forename: Bin
authors.initials: B
authors.lastname: Liang
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D002574:Cervical Vertebrae / Q000473:pathology; D019299:Decompression, Surgical / Q000009:adverse effects / Q000379:methods*; D017586:Diskectomy; D005260:Female; D006801:Humans; D007403:Intervertebral Disc / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D055959:Intervertebral Disc Degeneration / Q000000981:diagnostic imaging / Q000209:etiology / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D013123:Spinal Fusion / Q000009:adverse effects / Q000379:methods*; D016896:Treatment Outcome