Radiographic Risk Factors for Adjacent Segment Disease Following Anterior Cervical Discectomy and Fusion (ACDF): A Systematic Review and Meta-Analysis

被引：2

作者：

Mesregah, Mohamed Kamal ^{[1
]}

Baker, Melissa ^{[2
]}

Yoon, Camilla ^{[3
]}

Meisel, Hans-Joerg ^{[4
]}

Hsieh, Patrick ^{[5
]}

Wang, Jeffrey C. ^{[6
]}

Yoon, S. Tim ^{[7
]}

Buser, Zorica ^{[2
,6
,8
,10
]}

机构：

[1] Menoufia Univ, Dept Orthopaed Surg, Menoufia, Egypt

[2] Gerling Inst, New York, NY USA

[3] Emory Univ, Dept Orthoped, Atlanta, GA USA

[4] Dept Neurosurg, BG Klinikum Bergmannstrost Halle, Halle, Germany

[5] Univ Southern Calif, Keck Sch Med, Dept Neurosurg, Los Angeles, CA USA

[6] Univ Southern Calif, Keck Sch Med, Dept Orthopaed Surg, Los Angeles, CA USA

[7] Emory Univ, Dept Orthopaed Surg, Atlanta, GA USA

[8] NYU Grossman Sch Med, Dept Orthoped Surg, New York, NY 11215 USA

[9] AO Fdn, AO Spine, Davos, Switzerland

[10] NYU Grossman Sch Med, Gerling Inst, Dept Orthoped Surg, 94 9th St 1-222, Brooklyn, NY 11215 USA

来源：

GLOBAL SPINE JOURNAL | 2024年 / 14卷 / 07期

关键词：

anterior cervical discectomy and fusion; adjacent segment disease; radiographic parameters; risk factors; sagittal alignment; canal stenosis; ZERO-PROFILE DEVICE; DEGENERATION; OUTCOMES; SURGERY; PLATE; DECOMPRESSION; REOPERATION; STENOSIS; IMPACT;

D O I：

10.1177/21925682241237500

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Study Design Systematic review and meta-analysis. Objectives To assess the radiographic risk factors for adjacent segment disease (ASD) following anterior cervical discectomy and fusion (ACDF) for degenerative cervical spine pathologies. Methods PubMed, Embase and the Cochrane Library databases were searched up to December 2023. The primary inclusion criteria were degenerative spinal conditions treated with ACDF, comparing radiological parameters in patients with and without postoperative ASD. The radiographic parameters included intervertebral disc height, cervical sagittal alignment, sagittal segmental alignment, range of motion, segmental height, T1 slope, sagittal vertical axis (SVA), thoracic inlet angle (TIA), and plate to disc distance (PPD). Risk of bias was assessed for all studies. The Cochrane Review Manager was utilized to perform the meta-analysis. Results From 7044 articles, 13 retrospective studies were included in the final analysis. Three studies had "not serious" bias and the other 10 studies had serious or very serious bias. The total number of patients in the included studies was 1799 patients. Five studies included single-level ACDF, 2 studies included multi-level ACDF, and 6 studies included single or multi-level ACDF. On meta-analysis, the significant risk factors associated with ASD development were reduced postoperative cervical lordosis (mean difference [MD] = 3.35(degrees), P = .002), reduced last-follow-up cervical lordosis (MD = -3.02(degrees), P = .0003), increased preoperative to postoperative cervical sagittal alignment change (MD = -3.68(degrees), P = .03), and the presence of developmental cervical canal stenosis (Odds ratio [OR] = 4.17, P < .001). Conclusions Decreased postoperative cervical lordosis, greater change in cervical sagittal alignment and developmental cervical canal stenosis were associated with an increased risk of ASD following ACDF.

引用

页码：2183 / 2200

页数：18