Does kyphofic malalignment after anterior cervical fusion promote the degenerative process in adjacent intervertebral levels?

我们对前路减压融合术患者术后5年以上椎间隙退行性改变的原因进行了回顾性研究。本研究的目的是确定颈椎前路融合术后植骨塌陷所致的后凸畸形等排列异常是否促进融合附近椎间隙的退行性改变。我们在重新评估时通过X线片检查颈椎排列和邻近椎间隙的退行性改变，并分析它们之间的关系。我们还检查了有症状的患者和无症状的患者之间的差异。在排列不良的患者中，相邻椎间节段退行性改变的进展程度比那些有前凸排列的患者更大。有症状恶化的邻近融合的椎间隙退行性改变的患者的椎管直径比无症状的患者小。

We retrospectively studied the causes of degenerative change of intervertebral levels adjacent to fusion in patients who had undergone anterior decompression and fusion and who had been followed for more than 5 years. The aim of this study was to determine whether malalignment, such as kyphotic pattern, due to collapse of graft bone after anterior cervical fusion promotes degenerative change of intervertebral levels adjacent to fusion.We examined cervical alignment and degenerative change of adjacent intervertebral levels roentgenographically at the time of reassessment, and analyzed their relationship. We also examined the differences between symptomatic patients with degenerative change of intervertebral spaces adjacent to fixation and asymptomatic patients. In patients with malalignment, degenerative change of adjacent intervertebral levels progressed to a greater extent than in those with lordotic alignment. Patients with symptomatic deterioration of degenerative change of intervertebral spaces adjacent to fusion have a smaller spinal canal diameter than do asymptomatic patients.