Adjacent segment pathology: natural history or effect of anterior cervical discectomy and fusion? A 10-year follow-up radiological multicenter study using an evaluation scale of the ageing spine.
OBJECTIVE
Aim of this study is to compare late degenerative MRI changes in a subset of patients operated on with ACDF to a second subset of patients presenting indication to ACDF but never operated on.


METHODS
Patients from both subgroups received surgical indication according to the same criteria. Both subgroups underwent a cervical spine MRI in 2004-2005 and 10 years later in 2015. These MRI scans were retrospectively evaluated with a cervical spine ageing scale.


RESULTS
Comparing the two subset of patients both suffering from clinically relevant single-level disease returns no statistically significant difference in the degenerative condition of posterior ligaments, presence of degenerative spondylolisthesis, foraminal stenosis, diameter of the spinal canal, Modic alteration, and intervertebral discs degeneration at 10-year follow-up.


CONCLUSIONS
The adjacent segment degeneration represents, in the present cohort, a result of the natural history of cervical spondylosis rather than a consequence of fusion.
Neurosurgery Division, NESMOS Department, A.O. "Sant'Andrea", Sapienza University of Rome, Via di Grottarossa, 1035-1039, 00189, Rome, Italy. ale_pesce83@yahoo.it.
Alessandro
http://orcid.org/0000-0003-0250-4205
A
Pesce
Neurosurgery Division, Dipartimento Scienze Neurosensoriali, Rome Army Hospital "Celio", Sapienza University of Rome, Piazza Celimontana, 50, 00184, Rome, Italy.
Venceslao
V
Wierzbicki
Neurosurgery Division, Dipartimento Scienze Neurosensoriali, Rome Army Hospital "Celio", Sapienza University of Rome, Piazza Celimontana, 50, 00184, Rome, Italy.|Radiology Division, Dipartimento Scienze Scienze Radiologiche, Rome Army Hospital "Celio", Sapienza University of Rome, Piazza Celimontana, 50, 00184, Rome, Italy.
Emanuele
E
Piccione
Neurosurgery Division, IRCCS "Neuromed", Sapienza University of Rome, Via Atinense 18, Pozzilli, IS, Italy.
Alessandro
A
Frati
Neurosurgery Division, NESMOS Department, A.O. "Sant'Andrea", Sapienza University of Rome, Via di Grottarossa, 1035-1039, 00189, Rome, Italy.
Antonino
A
Raco
Neurosurgery Division, Dipartimento Scienze Neurosensoriali, Rome Army Hospital "Celio", Sapienza University of Rome, Piazza Celimontana, 50, 00184, Rome, Italy.
Riccardo
R
Caruso
D000328:Adult; D000367:Age Factors; D000375:Aging / Q000502:physiology; D000704:Analysis of Variance; D002574:Cervical Vertebrae / Q000503:physiopathology / Q000601:surgery*; D015331:Cohort Studies; D018450:Disease Progression; D017586:Diskectomy / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D055959:Intervertebral Disc Degeneration / Q000000981:diagnostic imaging / Q000601:surgery*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D018570:Risk Assessment; D013123:Spinal Fusion / Q000009:adverse effects / Q000379:methods*; D013997:Time Factors; D016896:Treatment Outcome
ACDF; Adjacent segment pathology; Ageing spine; Cervical arthroplasty; Cervical spondylosis; MRI