Research Progress Of Adjacent Segment Degeneration After Anterior Cervical Discectomy And Fusion

Cervical spondylosis is one of the most common orthopaedic diseases.In recent years,the incidence of cervical spondylosis gradually increased with the change of people’s life style and working environment,and the age of onset is also younger.Among all types of cervical spondylosis,myelopathy and radiculopathy are more common.Due to the degeneration of cervical intervertebral disc,cervical spinal cord compression,which led to neck and radiating arm pain and the damage of the nerve function,seriously affect the quality of life for the patients.At present,the main treatment of cervical spondylosis is operation.For the short-segment cervical spondylopathy,most orthopedic surgeons performed anterior cervical discectomy and fusion(ACDF).However,a large number of patients developed adjacent segment degeneration(ASD)after surgery.Adjacent segment degeneration is the degeneration of the normal segment due to the increase of local stress owing to the fusion of adjacent segments.It seriously influences the quality of life after operation,and some of patients had to undergo secondary surgery.ASD has attracted more and more attention from clinicians.Currently,there is no uniform conclusion about the mechanism of adjacent segment degeneration after anterior cervical discectomy and fusion.This paper summarizes the research progress of the incidence,pathogenesis and related factors by consulting the relevant literatures.Based on relevant literatures,possible factors associated with ASD following ACDF include age and sex,number and location of fusion segments,size of spinal canal,height of intervertebral space,preoperative and postoperative cervical curvature,PDD,pre-operative degeneration,the range of motion etc.The operator should make a full assessment of the patient,avoidthe above situation during operation as far as possible,It can significantly reduce the incidence of ASD after ACDF.