Original Article

Risk Factors for the Development of Adjacent Segment Disease Following Anterior Cervical Arthrodesis


  • Ezgi Akar
  • Mehmet Ufuk Akmil
  • Metin Orakdöğen
  • Hakan Somay
  • Merih İş

Med Bull Haseki 2015;53(2):120-123


The aim of this study was to clinically and radiologically evaluate the efficacy of anterior cervical discectomy and fusion (ACDF) in the treatment of adjacent level degeneration.


We retrospectively evaluated 89 patients (55 females, 34 males) who underwent ACDF. Adjacent segment degeneration findings were evaluated by investigating new osteophyte formation, growth of existing osteophytes, ossification of the anterior longitudinal ligament, presence of intervertebral disc space narrowing, sagittal alignment and range of motion (ROM) using serial radiographs and magnetic resonance imaging.


The mean age of the 89 patients was 41.3 (24-76) years. The mean follow-up duration was 34.3 (12-64) months. Radiographic evidence of adjacent segment degeneration was observed in 12 patients (13.4%). Nine (75%) patients had new complaints. Of the patients who had degenerative changes, 7 were (58%) were male, 5 (42%) were female; the mean age was 46 (30-62) years. It was observed that the level of fusion and the number of fusion did not increase the adjacent segment degeneration. All of 12 patients were observed to have a non lordotic cervical spine and increased ROM.


Development of degeneration at the level adjacent to region anterior cervical discectomy and fusion performed is higher compared to non-adjacent levels. The level of fusion and the number of fusion levels have no effect on the development of degeneration.

Keywords: Adjacent segment disease, anterior cervical fusion, cervical disc disease, disc degeneration

Full Text (Turkish)