Adjacent Vertebral Level Deterioration Increases After Cervical Fusion

A DGReview of :"Outcome of cervical spinal levels adjacent to anterior fusion: l ong-term follow-up"
The Spine Journal

By Elda Hauschildt

Cervical fusion surgery increases the deterioration of both overlying and underlying adjacent vertebral levels, French research confirms.

Investigators from Bordeaux University in Bordeaux report that deterioration of the overlying level increased from 54 to 81% over five years among patients with one- or two-level corpectomies. The increase was from 40 to 70% in patients with more than two corpectomies.

Deterioration of the underlying level also increased but only in patients with one- or two-level corpectomies. This increase was from 26 to 50%.

Cervical pain remained mild in these patients, the researchers note.

A previous study had followed 300 patients for 40 months after anterior cervical fusion surgery. Results of that study clearly showed there was a high frequency of degeneration, from 21% in young trauma cases to 57% in post-degenerative cases.

The researchers thus attempted to follow the same group of patients for an additional five years. They were able to follow 136 patients completely and partially followed 34 others. Telephone follow-up was done in 22 patients, eight others had died and the rest were lost to follow-up.

Follow-up included dynamic X-rays, clinical assessment and cervical pain analysis on a visual analogue scale.

"These results confirm that cervical fusion increases the deterioration of adjacent levels," the investigators concluded.

They note the gap closed between results of the trauma patients and other cases in the extended follow-up.
The Spine Journal, 2002;2:126-127. "Outcome of cervical spinal levels adjacent to anterior fusion: l ong-term follow-up"