A new article published in Spine examined several factors influencing adjacent segment disease that requires reoperation.
The study authors retroactively analyzed 1,038 consecutive patients who underwent primary anterior cervical spine arthrodesis for radiculopathy and/or myelopathy. One surgeon performed all the procedures. The researchers found:
1. There was a secondary surgery on adjacent segments at a relatively consistent rate — 2.4 percent of patients per year.
2. A Kaplan-Meier analysis predicted 22.2 percent of patients would need reoperation at adjacent segments by 10 years after surgery.
3. There were several factors increasing the risk of reparations at adjacent segments, including:
• Female sex
• Smoking
• Number of arthrodesis segments
4. Patients who had one- or two-segment arthrodesis reported 1.8 times greater risk of adjacent segment reoperation than patients who had arthrodesis at three or more segments.
5. The factors that did not significantly impact reoperation risk were
• Age
• Neurological diagnosis
• Diabetes
• Klippel-Feil syndrome
• Noncontiguous segment-type ossification of posterior longitudinal ligament