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BACKGROUND:

Adjacent segment disease (ASD) development is known to occur after anterior cervical discectomy and fusion (ACDF).

OBJECTIVE:

To study the relationship between index ACDF levels and the location of ASD development (above/below), as well as the effect of fusion length on ASD development.

METHODS:

We report 888 patients who underwent ACDF for cervical spondylosis over a twenty-year period at a single institution. Of these patients, 108 had re-do surgery due to symptomatic ASD. Patients were followed for an average of 92.4±52.6 months after the index ACDF.

RESULTS:

In agreement with previous ACDF case series, we found the highest rates of cervical spinal degenerative disease requiring surgery at C5/C6, followed by C6/C7. Interestingly, neither the inherent location of index ACDF nor the length of instrumented arthrodesis appeared to correlate with the propensity to develop ASD …