Clinical outcomes of additional surgery for adjacent segment disease after single-level anterior cervical decompression and fusion.

Abstract

Adjacent segment disease (ASD) is one of the problematic complications following anterior cervical decompression and fusion (ACDF). The impact of additional surgery with instruments is still unknown. The objective of this study was to investigate the surgical outcomes of additional ACDF with instruments for symptomatic ASD after an initial ACDF using autogenous iliac grafts without instruments. A total of 56 patients who underwent an additional ACDF with instruments for symptomatic new radicular or myelopathic symptoms from ASD between 2006 and 2012. In this study, subjects were 30 men and 26 women with a mean age of 59.2 ± 9.7 years (range, 50-70 years) at revision surgery. Clinical evaluations were performed preoperatively and repeated at 3 years after operation. There were no cases of intraoperative complications, major neurological or vascular, pseudoarthrosis or wound complications. All of them reported significant improvements in JOA, NDI and VAS on arm pain and neck pain from the preoperative means (P< 0.05). According to our study, additional ACDF with instruments had achieved favorable clinical results on patients who underwent initial ACDF using autogenous iliac grafts without instruments for symptomatic new radiculopathy or myelopathy.