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Adjacent level disease-background and update based on disc replacement data

  • Motion Preserving Spine Surgery (C Kepler, section editor)
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Current Reviews in Musculoskeletal Medicine Aims and scope Submit manuscript

A Correction to this article was published on 18 October 2017

This article has been updated

Abstract

Purpose of review

The precise etiology of adjacent segment disease following cervical spine surgery is controversial. Theories for development include inevitable changes secondary to the natural progression of the degenerative cascade and changes secondary to altered biomechanics of the fused cervical spine. Motion preserving techniques, such as cervical disc arthroplasties (CDA), have been introduced with the hopes of reducing the rates of adjacent segment pathology. Recently, 7-year data from the investigational device exemption (IDE) studies have been published. The purpose of this review is to provide an update on cervical adjacent segment disease incorporating this emerging data into the analysis.

Recent findings

Although the 7-year data for CDA has confirmed continued success, specifically regarding improved neck pain and reduced re-operation rates, the influence of CDA on reducing rates of adjacent segment pathology remains questionable. Although some studies have found more radiographic adjacent segment disease after anterior cervical discectomy and fusion (ACDF) compared to CDA, an association between these findings and clinical symptoms has not been established.

Summary

Cervical disc arthroplasty continues to outperform cervical disc fusion regarding some patient specific parameters, however, whether CDA reduces rates of radiographic and clinical adjacent segment pathology remains unknown. Without studies developed specifically to address this question, the answer remains elusive.

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Change history

  • 18 October 2017

    This article was published and transmitted with the lead author’s name listed incorrectly in the citation. The correct citation is, in full: Kaye, I.D. & Hilibrand, A.S. Curr Rev Musculoskelet Med (2017) 10: 147. https://doi.org/10.1007/s12178-017-9396-5 .

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Authors and Affiliations

  1. Rothman Institute at Thomas Jefferson University Hospital, 925 Chestnut Street, Philadelphia, PA, 19107, USA

    I. David Kaye & Alan S. Hilibrand

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  1. I. David Kaye
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  2. Alan S. Hilibrand
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Correspondence to I. David Kaye.

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Conflict of interest

Alan S. Hilibrand is a board member for AAOS, the Cervical Spine Research Society, and the North American Spine Society. He reports stock options for Amedica, Benvenue Medical, Lifespine, Nexgen, Paradigm Spine, PSD, Spinal Ventures, and Vertiflex. He also reports personal fees from Aesculap/B.Braun and Biomet.

I. David Kaye declares that he has no conflict of interest.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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The authors received no support regarding preparation of this manuscript.

This article is part of the Topical Collection on Motion Preserving Spine Surgery

A correction to this article is available online at https://doi.org/10.1007/s12178-017-9447-y.

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David Kaye, I., Hilibrand, A.S. Adjacent level disease-background and update based on disc replacement data. Curr Rev Musculoskelet Med 10, 147–152 (2017). https://doi.org/10.1007/s12178-017-9396-5

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