Comparing The Rate of Radiological and Clinical Adjacent Segment Degeneration After Simple Anterior Cervical Discectomy Versus Discectomy Plus Fusion

Abstract

Objective: To evaluate and compare the radiological changes on adjacent mobile segments and clinical findings in patients having undergone single-segment simple anterior cervical discectomy versus discectomy plus intervertebral fusion.Material and Methods: Twenty-five patients were treated with discectomy plus fusion and 20 patients with simple discectomy. Clinical pictures of the patients were evaluated with ODOM criteria before and 1 year after operation, and their improvement rates were calculated. The disc heights of superior and inferior adjacent segments, superior and inferior foramen heights, superior and inferior end plate heights of superior and inferior adjacent segments, new osteophyte development, segmental angulation and loss of cervical lordosis were evaluated on cervical radiographies before and 1 year after operation.Results: Although there were new degenerative findings in adjacent mobile segments in all patients when preoperative and postoperative measurements were compared, these radiological findings did not translate into clinical findings. In the fusion group, radiological degeneration findings were seen more frequently statistically; however, clinical results were not different between the two groups. On the other hand, loss of lordosis was significantly more frequent in the simple discectomy group.Conclusion: Although adding fusion to single-segment anterior cervical discectomy caused more frequent radiological degenerative changes in adjacent segments after 1 year compared to simple discectomy, clinical results were similar. It was thought that longer follow-up was necessary to observe clinical adjacent segment disease that was expected to become more frequent because of excessive mobility due to fusion.

Keywords

• discectomy
• intervertebral disc displacement
• spinal fusions - adverse effects