Is there an impression of cervical plating on the event of adjoining section degeneration following Smith-Robinson process ? A magnetic resonance imaging examine of 84 sufferers with a 24 yr follow-up.
Backbone J. 2018 Sep 06;:
Authors: Burkhardt BW, Simgen A, Dehnen M, Wagenpfeil G, Reith W, Oertel JM
BACKGROUND CONTEXT: Anterior cervical discectomy and fusion (ACDF) with out and with cervical plating (ACDF+CP) are accepted surgical methods for the remedy of degenerative cervical disc problems. The impact of CP on the event of adjoining section degeneration (ASD) stays unclear.
PURPOSE: To evaluate whether or not CP accelerates the degeneration of the adjoining and adjoining segments.
STUDY DESIGN / SETTING: That is an imaging cohort examine.
PATIENT SAMPLE: Retrospectively, a complete of 84 sufferers who underwent ACDF or ACDF+CP had been recognized. At last follow-up an MRI was carried out and evaluated on this examine.
MATERIALS AND METHODS: An MRI of 84 sufferers who underwent ACDF (46 sufferers) and ACDF+PS (38 sufferers) was carried out. The imply follow-up was 24 years (17-45 years). Not one of the sufferers had a repeat process within the cervical backbone. The grade of degeneration of the segments adjoining and adjoining to the fusion was assessed through a 5 step grading system (segmental degeneration index, or SDI) that features disc sign depth, anterior and posterior disc protrusion, narrowing of the disc area, and foraminal stenosis. Moreover, the disc peak (DH) and sagittal segmental angle (SSA) of fused segments had been measured.
RESULTS: A considerably (p< .001) larger SDI was recognized on the caudal adjoining section following ACDF in comparison with ACDF+CP. No different important variations had been recognized in sufferers following ACDF and ACDF+CP. Between 50% and 96% of all segments confirmed extreme degenerative adjustments in response to SDI. There was no important distinction in DH between the sufferers following ACDF and ACDF+CP. The SSA in sufferers who underwent ACDF+CP was considerably larger than within the ACDF sufferers (p= .002).
CONCLUSIONS: On this cohort of sufferers, cervical plating had no important impression on segmental degeneration and reduce of disc peak within the adjoining and adjoining segments. ACDF+CP appears to protect the lordotic alignment extra with respect to the SSA than ACDF.
PMID: 30195935 [PubMed – as supplied by publisher]