Clinical and radiological assessment of adjacent segment degenerative changes in cervical spine after instrumentation in indian scenerio

Abstract

OBJECTIVE: Over the last 50 years many authors have used cervical spine fusion as a treatment for degenerative spondylotic conditions, and it has become the standard of care for numerous pathologic conditions of the spine. However, since over the past two decades spinal fusion has been performed on younger patients and the rates of cervical spine surgery have increased. Here we have studied the incidence of the adjacent segment disease and the radiological changes of cervical cord at the level of previous operation and at the adjacent segment. METHODS: Non randomised, open level study done at territory care centre for a period of three years a total 51 operated cervical spine patients were studied. MRI of cervical spine was done in symptomatic patients. All the patients were followed up clinically and radiologically. RESULTS: Fifty one patients were followed up for minimum of 2 years (average 72.82 months) after cervical spine instrumentation. 23 patients had single or multiple co- morbidities. 29 (56.86%) patients developed adjacent segment degeneration following the primary surgery. Rate of re- surgery for the symptomatic ASD was 9.8% , Development of radiological or clinical ASD 54.9%.