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Segmental motion adjacent to anterior cervical arthrodesis: a prospective study.

Kolstad F, Nygaard ØP, Leivseth G

National Centre of Spinal Disorders, St. Olav University Hospital, Trondheim, Norway. Frode.Kolstad@ntnu.no

STUDY DESIGN: Prospective, observational study. OBJECTIVE: The present study describes in a prospective setting the kinematics changes occurring at segments adjacent to a one-level cervical arthrodesis. SUMMARY OF BACKGROUND DATA: The development of adjacent segment disease has been noticed by many clinicians. Whether symptoms develop due to fusion induced accelerated spondylosis or due to a natural development in a predisposed person is currently under debate. The motivation for introducing motion preservation procedures in the neck is primarily to protect the patients from developing symptomatic adjacent disc disease. To accept this rationale, it has to be demonstrated that a fusion creates an unfavorable biomechanical situation at adjacent levels. METHODS: Forty-six patients underwent standard anterior cervical decompression and fusion using a cylindrical cage implant. Lateral radiographic views of the cervical spine in flexion and extension were obtained before surgery, and at 12 months of follow-up. Employing Distortion Compensated Roentgen Analysis, rotational and translational motion at adjacent levels was quantified prospectively. RESULTS: Rotational and translational motion at adjacent cranial and caudal levels did not exhibit a significant change between the preoperative state and the state 12 months after the operation. CONCLUSION: The assumption of an iatrogenically caused increased mobility by a one-level cervical fusion could not be confirmed 12 months after surgery.

Published 5 March 2007 in Spine, 32(5): 512-7.
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