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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颈椎手术邻近节段疾病的预测因素：一项巢式病例对照研究。

研究设计：巢式病例对照研究。目的：报告了相当比例的ACDF术后患者放射学邻近节段退变。只有一部分患者会出现临床症状，最终需要进行第二次颈椎手术（ssd）。我们的回顾性观察研究，前瞻性数据收集，旨在考虑颈椎矢状平衡对acdf术后第二次手术的潜在影响。在病例和对照组之间评估四个关键的潜在预测因素。方法：2014年1月1日至2020年1月1日，在里尔大学医院脊柱科对1078例ACDF患者进行手术治疗。我们确定了19例病例和76例匹配的对照。病例定义如下：> 18 y/o，在与sssd相关的第二个ACDF上进行手术。对照组患者在研究期间未接受第二次颈椎手术。结果：ssd患病率为1.76%。颈椎矢状轴（p = 0.12）和颈椎前凸（p = 0.40）均与ssd无关。然而，我们报道了手术节段数和术后局部后凸是ssd的危险因素的强烈趋势（分别p = 0.056和p = 0.06）。结论：我们没有报道颈椎平衡参数如颈椎前凸或cSVA对2年后第二次颈椎手术风险的明确影响。尽管如此，我们强调了初始手术颈椎节段数与ssd的发生和早期局部后凸的存在之间的潜在相关性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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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.