The Effect of Plating on Adjacent Segments in Anterior Cervical Discectomy and Fusions in Patients with Degenerative Spine Disease: A Retrospective Cohort Study

• Published in: Spine Surgery and Related Research 2022/07/27, Vol.6(4), pp.350-357
• Main Authors: Heemskerk, Johan L., Vega, Carlos Perez, Domingo, Ricardo A., Richter, Kent R., Richter, Reed, Vivas-Buitrago, Tito G., Neal, Matthew T., Quinones-Hinojosa, Alfredo, Abode-Iyamah, Kingsley
• Format: Article
• Language: English
• Subjects: ACDF; adjacent segment degeneration; adjacent segment pathology; adjacent-level ossification development; ALOD; anterior cervical discectomy and fusion; ASD; degenerative cervical spine disease; Original
• ISSN: 2432-261X; 2432-261X
• DOI: 10.22603/ssrr.2021-0073

Introduction: Plate distance is correlated with an increased incidence of adjacent segment pathologies (ASP). However, a correct plate-to-disk distance >5 mm is often not achieved. Therefore, this study aimed to quantify the effect of short plate-to-disk distance on the development of ASP using epidemiological measures in patients with cervical degenerative spine disease undergoing single-level anterior cervical discectomy and fusion (ACDFs).Methods: Medical records of all patients with cervical degeneration undergoing single-level ACDF with plating (between January 2015 and December 2017), and a follow-up of at least 1 year, were reviewed retrospectively. Radiologic and clinical outcomes were assessed preoperatively, postoperatively, and at last follow-up. The plate-to-adjacent disk distance was measured, and epidemiological measures were calculated to quantify the risk on adjacent-level ossification development (ALOD) and adjacent segment degeneration (ASD).Results: Thirty-eight (47.5%) of the 80 patients developed ALOD, and 12 (15.0%) developed ASD after a 2-year follow-up. The incidence of ALOD was significantly lower if the plate was >5 mm away from the adjacent disk space compared to 5 mm away from the adjacent disk.