Adjacent Level disease in the Cervical Spine

12/2/16

Upper Chesapeake Medical Center

Spine Conference

2004

2005 at the time, 51 year old womans/p c5c6 acdf 1990 with iliac crest

MRI evaluation 63 asymptomatic subjects, 27 years old to 73 years old, spouses included, scans mixed up with abnormals and sent to three neuroradiologists,

62 yo woman neck pain posterior with occipital pain PMH: ACDF iliac crest 1990 R approachACDF PEEK 2007 R approach

Polyetheretherketone (PEEK) cage

Polyether ether ketone (PEEK) is a colourless organic thermoplastic polymer in the polyaryletherketone (PAEK) family, used in engineering applications. Because of its robustness, PEEK is used to fabricate items used in demanding applications, including bearings, piston parts, pumps, HPLC columns, compressor plate valves, and cable insulation.

Dr. Robert A RobinsonJohns Hopkins Hospital Orthopaedicsurgeon

Robinson RA, Smith GW. Anterolateral cervical disc removal and interbody fusion for cervical disc syndrome. Bull John Hopkins Hosp. 1955;96:223–224.

Robinson R, Walker A, Ferlinc D, Wiedìcking D. The results of an anterior interbody fusion of the cervical spine. J Bone Joint Surg Am. 1962;44:1569–1587

c2c3

c3c4

c5

c4c5

c6c7

• Adjacent segment deterioration

• 3%/year adjacent segment disease

• 25% in 10 years

• RiskFactors: pre-existing degeneration, index levels C5C7,

Spine J. 2004 Nov-Dec;4(6 Suppl):190S-194S.Adjacent segment degeneration and adjacent segment disease: the consequences of spinal fusion?Hilibrand AS1, Robbins M.

thanks