Correlation of different intervertebral heights during anterior cervical discectomy and fusion with reoperation for adjacent segment disease

WANG Changfeng; CHEN Wei; YANG Le; GU Wen

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Medical Journal of the Chinese People Armed Police Forces ›› 2024, Vol. 35 ›› Issue (12) : 1018-1023.

Correlation of different intervertebral heights during anterior cervical discectomy and fusion with reoperation for adjacent segment disease

WANG Changfeng, CHEN Wei, YANG Le, GU Wen

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Abstract

Objective To investigate the correlation between intervertebral height (IH) during anterior discectomy and fusion (ACDF) for cervical disc herniation and reoperation after adjacent segment disease (ASD). Methods A total of 68 cases of cervical disc herniation treated by operation in Jiangsu Provincial Corps Hospital of Chinese People’s Armed Police Force from January 2005 to November 2020 were selected. IH was measured 3 days after ACDF operation and divided into 4 groups according to the value. Preoperative neutral IH was, 130%-140% (group A), 141%-150% (group B), 151%-160% (group C), and 161%-170% (group D). Follow-up observation was conducted to observe three aspects, the relationship between IH and Cobb improvement angle of operative segment (C_n), C_2-7Cobb improvement angle, thoracic inlet angle (TIA) and T₁ slope (T₁S), the IH changes in the upper and lower adjacent segments after ASD, and the effect of different IH on reoperation after ASD. Results The rate of reoperation after ASD in group B was the lowest (7%). Compared with group B, IH in adjacent segments of groups A, C and D significantly decreased (P<0.05), and the difference was statistically significant (P<0.05). Correlation analysis showed that intervertebral height increment (ΔIH) was weakly correlated with the Cobb improvement angle of operative segment (C_n) (r=0.426, P=0.028), but not significantly correlated with the change of C_2-7Cobb, TIA or T₁S. In group C and group D, the number of reoperation for adjacent segment disease accounted for 71.4% of the total number of reoperations. Conclusions Single gap IH greater than 150% before operation is a high risk factor for the reoperation for ASD. The 140%~150% group is characterized by the least ASD, which is a relatively ideal IH.

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cervical vertebra / anterior cervical discectomy and fusion / single gap / intervertebral height / adjacent segment degeneration

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WANG Changfeng, CHEN Wei, YANG Le, GU Wen. Correlation of different intervertebral heights during anterior cervical discectomy and fusion with reoperation for adjacent segment disease[J]. Medical Journal of the Chinese People Armed Police Forces. 2024, 35(12): 1018-1023

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