Predictive factors of surgical adjacent segment disease in the cervical spine: A nested case-control study

IF 1.5 4区医学 Q4 CLINICAL NEUROLOGY

Neurochirurgie Pub Date : 2025-02-25 DOI:10.1016/j.neuchi.2025.101651

Henri-Arthur Leroy , Pierre De Buck , Tuong Lu , Amélie Toubol , Boulos Ghannam , Pierre Haettel , Richard Assaker

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引用次数: 0

Abstract

Study design

Nested case-control study.

Objective

Radiological adjacent segment degeneration is reported in a significant proportion of patients operated on following ACDF. Only a part of them will experience clinical symptoms, ultimately requiring a second cervical spine surgery (_SASD). Our retrospective observational study, with prospective data collection, aims at considering the potential influence of cervical sagittal balance on post-ACDF second surgery based on postoperative imaging follow-up. Four key potential predictive factors were evaluated between cases and controls.

Methods

Between January 1st, 2014, to January 1st, 2020, 1078 patients were operated on for ACDF in the Spine Department of Lille University Hospital. We identified 19 cases and 76 matched controls. Cases were defined as follow: >18 y/o, operated on for a second ACDF related to a _SASD. Controls patients did not undergo a second cervical surgery during the study period.

Results

The prevalence of _SASD was 1.76%. Neither the cervical sagittal axis (p = 0.12), nor the cervical lordosis (p = 0.40) were related to _SASD. However, we reported a strong tendency for the numbers of levels operated on and the postoperative local kyphosis to be risk factors of _SASD (respectively p = 0.056 and p = 0.06).

Conclusion

We did not report a clear impact of the cervical spine balance parameters such as cervical lordosis or cSVA on the risk of second cervical surgery at 2 years. Though, we highlighted the potential correlation between the initial number of cervical spine levels operated on and the occurrence of sASD and the presence of early local kyphosis.

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来源期刊

Neurochirurgie 医学-临床神经学

CiteScore

2.70

自引率

6.20%

发文量

100

审稿时长

29 days

期刊介绍： Neurochirurgie publishes articles on treatment, teaching and research, neurosurgery training and the professional aspects of our discipline, and also the history and progress of neurosurgery. It focuses on pathologies of the head, spine and central and peripheral nervous systems and their vascularization. All aspects of the specialty are dealt with: trauma, tumor, degenerative disease, infection, vascular pathology, and radiosurgery, and pediatrics. Transversal studies are also welcome: neuroanatomy, neurophysiology, neurology, neuropediatrics, psychiatry, neuropsychology, physical medicine and neurologic rehabilitation, neuro-anesthesia, neurologic intensive care, neuroradiology, functional exploration, neuropathology, neuro-ophthalmology, otoneurology, maxillofacial surgery, neuro-endocrinology and spine surgery. Technical and methodological aspects are also taken onboard: diagnostic and therapeutic techniques, methods for assessing results, epidemiology, surgical, interventional and radiological techniques, simulations and pathophysiological hypotheses, and educational tools. The editorial board may refuse submissions that fail to meet the journal''s aims and scope; such studies will not be peer-reviewed, and the editor in chief will promptly inform the corresponding author, so as not to delay submission to a more suitable journal. With a view to attracting an international audience of both readers and writers, Neurochirurgie especially welcomes articles in English, and gives priority to original studies. Other kinds of article - reviews, case reports, technical notes and meta-analyses - are equally published. Every year, a special edition is dedicated to the topic selected by the French Society of Neurosurgery for its annual report.