Abstract:
STUDY DESIGN:Retrospective radiographic analysis. OBJECTIVE:To retrospectively review a group of patients undergoing anterior cervical discectomy and fusion (ACDF) to determine the relative risk of adjacent level disc degeneration after incorrect needle localization. SUMMARY OF BACKGROUND DATA:The needle puncture technique is a well-established method to cause disc degeneration in experimental animal studies. The risk for accelerated degeneration because of needle puncture in humans is unknown. METHODS:A retrospective radiographic analysis of 87 consecutive patients after single or 2-level ACDF with anterior plate instrumentation was performed. Perioperative and follow-up radiographs were used to grade disc degeneration according to a previously described scale. RESULTS:Eighty-seven patients were included in the study (36 underwent 1-level ACDF, and 51 underwent 2-level ACDF). Seventy-two had correct needle localization at the level of planned surgery; 15 had incorrect needle localization (1 level above the operative level). There were no differences between the 2 groups in age, sex and length of follow-up. Patients in the incorrectly marked group were statistically more likely to demonstrate progressive disc degeneration with an odds ratio of 3.2. There was no correlation between age and length of follow-up with development of disc degeneration. CONCLUSION:There is a 3-fold increase in risk of developing adjacent level disc degeneration in incorrectly marked discs after ACDF at short-term follow-up. This may indicate that either needle related trauma or unnecessary surgical dissection contributes to accelerated adjacent segment degeneration.
journal_name
Spine (Phila Pa 1976)journal_title
Spineauthors
Nassr A,Lee JY,Bashir RS,Rihn JA,Eck JC,Kang JD,Lim MRdoi
10.1097/BRS.0b013e3181913872subject
Has Abstractpub_date
2009-01-15 00:00:00pages
189-92issue
2eissn
0362-2436issn
1528-1159pii
00007632-200901150-00014journal_volume
34pub_type
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