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Korean J Spine > Volume 4(3); 2007 > Article
Adjacent-level Degeneration in Cervical Spondylosis with Single Level Anterior Cervical Interbody Fusion using the Cervical Cage
Jae-Won Jung, M.D., Sang-Gu Lee, M.D., Dea-Yong Kim, M.D., Chan-Jong Yoo M.D., Woo-Kyung Kim, M.D., Chan Woo Park, M.D.
Department of Neurosurgery, Gachon Medical University, Gil Medical Center, Incheon, Korea
퇴행성 경추질환자에서 단독 Cage를 이용하여 시행한 단분절 추체 골유합술 후 발생한 인접분절의 퇴행성 변화
정재원 ・ 이상구 ・ 김대용 ・ 유찬종 ・ 김우경 ・ 박찬우
가천대학교 의과대학 중앙길병원 신경외과학교실
Objective: Anterior cervical discectomy and fusion(ACDF) is a well-established operative technique for the treatment of cervical spondylosis. However, a number of studies have demonstrated acceleration of degeneration at the adjacent segment in any follow. The goal of this study is to review the occurrence of adjacent segment degeneration, the change of symptoms and the change of motion ranges of vertebral joints adjacent to fused level in cervical spine.
Materials and Methods: Between January 2001 and December 2003, 198 patients who underwent ACDF for degenerative conditions of cervical spine were evaluated. This study included 24 patients undergoing one-level fusion with cage and without plating. We analyzed clinical presentations, the flexion-extension angle(FEA) measured from dynamic views of cervical spine and adjacent level degeneration by means of changes of disc height and osteophyte formation at preoperative and post-operative period.
Results: In follow up periods, there was no patient worsen clinical symptoms. Change of adjacent disc height occurred in 11 levels(22.9%), and change of ostehophyte was occurred in 10 levels(20.8%). FEA adjacent to the fusion changed by more than 4 degrees in 4 of the 24 patients. However, on average, there was no difference between preoperative and follow-up FEA.
Conclusions: Clinical symptoms, disc height, ostehophyte, and intervertebral motion at the adjacent levels were not sig- nificantly affected by ACDF. The clinically observed degenerative change at adjacent segments in the cervical spine was more likely to be attributed to natural progression of the spondylotic process as opposed to biomechanical effect of the instrumentation or fusion.
Keywords: CervicalㆍAdjacent levelㆍDegenerationㆍFlexion-extension angle

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