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Reoperation rate of 2.4% per year seen for adjacent segment pathology after anterior cervical arthrodesis
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LYON, France — Adjacent segment pathology tended to develop more often after fusions at one or two cervical levels, and smoking and female gender were significant risk factors for clinical adjacent segment pathology, according to results reported here.
“The instance of reoperation rate for [adjacent segment pathology] ASP was 2.4% per year. A Kaplan-Meier analysis predicted the disease-free survival of adjacent segments was 91.7% at 5 years and 77.8% at 10 years. This research suggested that 8.3% of patients needed an additional operation within 5 years and 22.2% by 10 years,” Jae Chul Lee, MD, of Seoul, Korea, said at the EuroSpine Annual Meeting.
Lee presented findings of a retrospective study he and investigators in the Cervical Spine Service in the Department of Orthopedic Surgery at Washington University School of Medicine, in St. Louis, conducted when he was in training there.
For the 1,038 patients included in the study, two spine surgeons reviewed hospital records, office charts and information in a prospective database to identify patients. Patients who had not been contacted in the last 2 years were reached via questionnaires or phone interviews to determine if they had undergone any surgeries adjacent to the initially fused cervical segments.
In addition to determining the annual incidence of ASP, Lee and colleagues found ASP was most common at C5-6 and C6-7.
“The risk of C5-6 level was 4.4 times greater than C2-3,” Lee said.
He said smokers and women are at a greater risk of reoperation for ASP with 1.9 times and 1.7 times the risk, respectively, of developing ASP. Although the researchers studied the presence of Klippel-Feil anatomy and ossification of the posterior longitudinal ligament in these patients, neither condition proved to be a risk factor for ASP in this investigation, according to Lee. – by Susan M. Rapp
Reference:
Lee JC. Paper #X11. Presented at: EuroSpine Annual Meeting; Oct. 1-3, 2014; Lyon, France.
Disclosure: Lee is affiliated with Asian Spine Journal.