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Titel: Is there an impact of cervical plating on the development of adjacent segment degeneration following Smith-Robinson procedure? A magnetic resonance imaging study of 84 patients with a 24-year follow-up
VerfasserIn: Burkhardt, Benedikt W
Simgen, Andreas
Dehnen, Matthias
Wagenpfeil, Gudrun
Reith, Wolfgang
Oertel, Joachim M
Sprache: Englisch
Titel: The spine journal
Bandnummer: 19
Heft: 4
Seiten: 587-596
Verlag/Plattform: Springer
Erscheinungsjahr: 2019
DDC-Sachgruppe: 610 Medizin, Gesundheit
Dokumenttyp: Journalartikel / Zeitschriftenartikel
Abstract: Anterior cervical discectomy and fusion (ACDF) without and with cervical plating (ACDF+CP) are accepted surgical techniques for the treatment of degenerative cervical disc disorders. The effect of CP on the development of adjacent segment degeneration (ASD) remains unclear. To assess whether CP accelerates the degeneration of the adjacent and adjoining segments. This is an imaging cohort study. Retrospectively, a total of 84 patients who underwent ACDF or ACDF+CP were identified. At final follow-up, an MRI was performed and evaluated in this study. An MRI of 84 patients who underwent ACDF (46 patients) and ACDF+PS (38 patients) was performed. The mean follow-up was 24 years (17–45 years). None of the patients had a repeat procedure in the cervical spine. The grade of degeneration of the segments adjacent and adjoining to the fusion was assessed via a five-step grading system (segmental degeneration index, or SDI) that includes disc signal intensity, anterior and posterior disc protrusion, narrowing of the disc space, and foraminal stenosis. Furthermore, the disc height (DH) and sagittal segmental angle (SSA) of fused segments were measured. A significantly (p<.001) greater SDI was identified at the caudal adjacent segment following ACDF compared to ACDF+CP. No other significant differences were identified in patients following ACDF and ACDF+CP. Between 50% and 96% of all segments showed severe degenerative changes according to SDI. There was no significant difference in DH between the patients following ACDF and ACDF+CP. The SSA in patients who underwent ACDF+CP was significantly greater than in the ACDF patients (p=.002). In this cohort of patients, cervical plating had no significant impact on segmental degeneration and decrease of DH in the adjacent and adjoining segments. ACDF+CP seem to preserve the lordotic alignment more with respect to the SSA than ACDF.
DOI der Erstveröffentlichung: 10.1016/j.spinee.2018.09.001
URL der Erstveröffentlichung: https://www.sciencedirect.com/science/article/abs/pii/S1529943018311203
Link zu diesem Datensatz: urn:nbn:de:bsz:291--ds-403986
hdl:20.500.11880/36319
http://dx.doi.org/10.22028/D291-40398
ISSN: 15299430
Datum des Eintrags: 28-Aug-2023
Fakultät: M - Medizinische Fakultät
Fachrichtung: M - Medizinische Biometrie, Epidemiologie und medizinische Informatik
M - Neurochirurgie
Professur: M - Prof. Dr. Joachim Oertel
M - Keiner Professur zugeordnet
Sammlung:SciDok - Der Wissenschaftsserver der Universität des Saarlandes

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