Impact of over distraction on occurrence of axial symptom after anterior cervical discectomy and fusion.

OBJECTIVE: A retrospective review was undertaken to evaluate the impact of over distraction on cervical axial symptoms (AS) after anterior cervical discectomy and fusion (ACDF). METHODS: The retrospective review included 421 patients who underwent ACDF for one or two segments. Of these, 78 patients for whom complete follow-up data were available were selected for inclusion in the analysis. X-rays of the cervical vertebra were performed immediately after the surgery, 3 months postsurgery, and at a final follow up (6-24 months). According to the presence/absence of AS, the patients were divided into a symptom group (Group S) and a nonsymptom group (Group N). The ratio of intervertebral height change, change in the overall cervical curvature, change in the local curvature of the surgical segment, cervical total range of motion (ROM), and Japanese Orthopaedic Association (JOA) recovery rate were compared and analyzed. A linear regression analysis of the ratio of intervertebral height change and the symptom and severity of the AS according to the Visual Analogue Scale (VAS) was carried out. RESULTS: The total incidence of AS was 33.97%. C5 nerve root palsy occurred in one case in Group S after the surgery. The neurologic symptoms of both groups were significantly alleviated after the surgery. The ratio of intervertebral height change in Group S was significantly higher than that in Group N at the last follow-up (P < 0.05). However, the changes in the overall cervical curvature, local curvature of the surgical segment, cervical ROM, and JOA recovery rates were not statistically significant (P > 0.05). In Group S, 37% of the patients had symptoms that occurred in the chest area, and the ratio of intervertebral height change was significantly positively correlated with the VAS score of the AS (r = 0.893). CONCLUSIONS: The occurrence of postoperative AS will significantly increase if the ratio of intervertebral height change of the surgical segment after ACDF is over 10%.

Correlation of height change of intervertebral space of fused segment with axial synptoms after anterior cervical fusion / 中国矫形外科杂志

[Objective] To investigate the height change of intervertebral space after anterior cervical fusion and its relation to neck axial symptoms.[Method]Totally 122 patients receiving anterior cervical fusion were followed up for 2 to 5 years,average 3.9 years.The height change of intervertebral space of the fused segment on X-rays were evaluated before,3 months and 2 years after operation.All patients were classified into 3 groups by means of the postoperative height change of intervertebral space.The axial symptoms after operation were observed and analyzed during follow-up.[Result]The incidence of neck axial symptoms was 54.55%,25.84% and 45.45%,respectively.There were significant differences in statistical analysis in group A group B,group B to group C(x2=7.18,P0.0125).[Conclusion]There is significant relation between height change of intervertebral space and neck axial symptoms after anterior cervical fusion.