Abstract
BackgroundASD is a relatively common degenerative alteration after cervical surgery which occurs above or below the fused segment. In addition, some patients may need reoperation to treat severe ASD after the primary surgery. It was considered that sagittal balance is correlated with postoperative clinical outcomes; however, few studies have reported the influence of sagittal balance on ASD. The present study is designed to investigate whether sagittal balance impacts the pathology of adjacent segment disease (ASD) in patients who undergo anterior cervical surgery for degenerative cervical disease.MethodsDatabases including Pubmed, Embase, Cochrane library, and Web of Science were used to search for literature published before June 2018. Review Manager 5.3 was used to perform the statistical analysis. Sagittal balance parameters before and after surgery were compared between patients with and without ASD. Weighted mean difference (WMD) was summarized for continuous data and P < 0.05 was set for the level of significance.ResultsA total of 221 patients with ASD and 680 patients without ASD from seven articles were studied in this meta-analysis. There were no significant differences in most sagittal balance parameters between the two groups, except for postoperative cervical lordosis (CL) (WMD -3.30, CI -5.91, − 0.69, P = 0.01).ConclusionsSome sagittal balance parameters may be associated with the development of ASD after anterior cervical surgery. Sufficient restoration of CL may decrease the incidence of ASD. The results in present study needed to be expanded carefully and further high-quality studies are warranted to investigate the impact of sagittal balance on ASD.
Highlights
Cervical degenerative disease is common among elderly people, and manifests as neck pain, cervical radiolopathy and myelopathy [1]
Selection criteria The eligible studies included in this systematic review and meta-analysis met the following inclusion criteria: (1) randomized controlled trials or comparative studies of patients undergoing anterior cervical surgery; (2) patients were divided into two groups: those with Adjacent segment disease (ASD) and those without ASD; (3) measured at least one sagittal balance parameter of the cervical spine; (4) follow-up time more than 1 year
Thirty-nine articles were subsequently excluded for having no comparative data, no anterior cervical surgery, or being comment/editorial articles
Summary
Cervical degenerative disease is common among elderly people, and manifests as neck pain, cervical radiolopathy and myelopathy [1]. The surgical procedure for treating this disease can effectively improve radiographic and clinical outcomes, and has been frequently used in the past few Adjacent segment disease (ASD) refers to recurrent radicular or myelopathic symptoms from adjacent degeneration after surgery [7]. It has been recognized as an important complication after anterior cervical discectomy and fusion, and may be related to many factors [7]. The present study is designed to investigate whether sagittal balance impacts the pathology of adjacent segment disease (ASD) in patients who undergo anterior cervical surgery for degenerative cervical disease
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