Clinical Observation on Adjacent Segment Degeneration in Two-Level Anterior Cervical Hybrid Surgery
Objective:To observe the occurrence and development of adjacent segment degeneration(ASD)after two-level anterior cervical hybrid surgery(HS).Methods:49 patients who underwent double-segment HS from February 2015 to September 2022 were retrospectively analyzed.According to the relative positions of the two surgical methods of HS,it is divided into ACDF/ACDR group and the ACDR/ACDF group.Japanese orthopedic association(JOA)scores,cervical spine physiological curvature,range of motion(ROM),Rydman classification,Miyazaki classification,new incidence rate of ASD and surgical complications of the upper and lower adjacent segments of the two groups were compared before surgery and at the final follow-up.Results:There were 15 cases in the ACDF/ACDR group and 34 cases in the ACDR/ACDF group,27 males and 22 females,age(60.14±15.16)years,follow-up time(36.00±12.13)months.The JOA scores of the two groups at the last follow-up increased significantly.Compared with preoperative and postoperative,there were no significant changes in the physiological curvature and ROM of the cervical spine in the two groups.Comparing between groups,there was no significant difference in the new inci-dence rate of ASD between the two groups.The overall new incidence rate of ASD in the lower adjacent segments of the two groups was 36.7％,which was higher than the 22.4％new incidence rate of ASD in the upper adjacent segments,but it was not significantly higher.Conclusion:Most patients already have varying degrees of ASD before undergoing HS,different surgical selection methods for HS will not significantly affect the postoperative symptom improvement and the occurrence and de-velopment of ASD.The new rate of ASD in the lower adjacent segments after HS tends to be more than that in the upper adjacent segments,but there is no significant difference.
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