Clinical Study Of Adjacent Segment Degeneration After Lower Cervical Spine Fusion

Objective:To explore the influencing factors of adjacent segment degeneration after cervical keyboard resection and fusion.Methods:Patients who underwent spinal surgery in the First Affiliated Hospital of Xinjiang Medical University from December 2013 to December 2017 who underwent anterior cervical discectomy and fusion(ACDF)in the same surgical team were included.According to the inclusion and exclusion criteria,90cases were selected from 158 cases to be included in the study,including 49 males and 41females.The age of patients at the time of surgery was 43 to 71 years,with an average of55.32±8.57 years.36.89±12.15 months.Record the subject's age,sex,body mass index(BMI),duration of preoperative symptoms,number and location of fusion segments involved in the operation before,during and after the last follow-up.And the Japanese Orthopaedic Association JOA score,pain visual simulation VAS score and cervical dysfunction index NDI score and so on.The angles of C2 and C7(C2-7),the cervical spine ratio,T1 slope,and the height of the upper and lower adjacent segments were measured and recorded by cervical X-rays and MRI at the time of preoperative,postoperative,and final follow-up.Patients were divided into the non-ASD group and the ASD group according to the diagnostic criteria of ASD imaging in adjacent segments.The t-tests or?~2-tests were used to determine significant differences between groups,and multiple logistic regression analysis was used to determine the analysis factors associated with ASD.Result:At the last follow-up,the incidence of ASD was 21.1%.There were no statistical differences in gender,number of fusion segments,cervical spine ratio,and height of the adjacent intervertebral space(P>0.05).Logistic regression analysis showed that:age,duration of symptoms,C2-7 angle and T1 slope,as well as JOA score,VAS score,NDI score were statistically significant(P<0.05).Conclusion:Patients with ACDF who are older and have cervical sagittal imbalances have longer and worse preoperative symptoms more likely to develop ASD.