Zeng Yan, Dang Geng-ting, Ma Qing-jun
Department of Orthopaedics, Third Hospital of Beijing University, Beijing 100083, China.
Zhonghua Wai Ke Za Zhi. 2004 Dec 22;42(24):1481-4.
To observe the relationship of adjacent segment degeneration and neck symptom after anterior cervical fusion.
Making follow-up to 66 cases who had accepted anterior cervical fusion for 1 - 16 years, average 10.5 years. Observe the mobilization and gliding degree of adjacent segment in flexion-extension X-ray film, neck symptom, and the relationship of them. In 59 of these patients, the mobilization of entire cervical spine and non-fusion segment was observed before/after operation.
The incidence of adjacent segment instability in follow-up term was 72.7%, and 40.9% of all patients had significant neck symptom. The rate of significant neck symptom in patients who had instability was 48%, whereas which in patients without instability was 18.8%, and the difference was statistically significant (P < 0.05). The difference of mild instability and severe instability was not statistically significant (P > 0.1). The mobilization of entire cervical spine decreased obviously (P < 0.001). The mobilization of adjacent segment increased obviously (P < 0.01), and which of non-adjacent segment had no change (P > 0.05).
Majority of patients who have accepted anterior cervical fusion possessed instability of adjacent segment, but many of them have no symptoms. Adjacent segment instability is one of the reasons that induce neck symptoms.
观察颈椎前路融合术后相邻节段退变与颈部症状的关系。
对66例行颈椎前路融合术1至16年（平均10.5年）的患者进行随访。观察屈伸位X线片上相邻节段的活动度和滑移程度、颈部症状及其相互关系。其中59例患者观察了手术前后整个颈椎及未融合节段的活动度。
随访期相邻节段不稳定发生率为72.7%，40.9%的患者有明显颈部症状。不稳定患者中明显颈部症状发生率为48%，无不稳定患者中为18.8%，差异有统计学意义（P<0.05）。轻度不稳定与重度不稳定之间差异无统计学意义（P>0.1）。整个颈椎的活动度明显降低（P<0.001）。相邻节段活动度明显增加（P<0.01），非相邻节段活动度无变化（P>0.05）。
多数接受颈椎前路融合术的患者存在相邻节段不稳定，但许多患者无症状。相邻节段不稳定是诱发颈部症状的原因之一。
