The Comparison of Multi-level Fusion versus One-level Fusion to the Development of Adjacent Level Degeneration in Anterior Cervical Arthrodesis with PEEK Cage and Plate Augmentation for the Degenerative Cervical Spinal Disorders / 대한정형외과학회잡지

ABSTRACT

PURPOSE: The purpose of this study was to analyze the effect of multi-level fusion in the development of adjacent level degeneration (ALD) in anterior cervical arthrodesis, as a treatment for degenerative cervical disease. MATERIALS AND METHODS: Retrospectively, we analyzed 127 patients who underwent arthrodesis with PEEK cage and plate construction for the treatment of degenerative cervical disease. The mean patient age was 54.4+/-10.6 years and the average follow-up period was 48.5+/-8.5 months. Group A composed of 55 patients who underwent one level fusion and group B composed of 72 patients who underwent two or three level fusion. We evaluated and compared the severity of ALD, such as the stage of osteophyte formation, the grade of ALD, and the incidence of ALD according to 4 grading system. RESULTS: The stage of osteophyte formation was 1.62+/-0.85 points in group A and 2.43+/-1.14 points in group B (p=0.02). The grade of ADL was 1.71+/-0.94 points in group A and 2.38+/-1.11 points in group B (p=0.01). The incidence of symptomatic ALD (radiculopathy and/or myelopathy) was 3.6% (2/55 cases) in group A and 4.2% (3/77 cases) in group B (p>0.05). CONCLUSION: Multi-level fusion can accelerate the severity of adjacent level degeneration as compared with one level fusion, but there was no correlation in the incidence of symptomatic adjacent level degeneration to the fusion level number after anterior cervical arthrodesis for degenerative cervical diseases.