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자료유형
학술저널
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대한척추외과학회 Asian Spine Journal Asian Spine Journal Vol.9 No.6
발행연도
2015.1
수록면
942 - 951 (10page)

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Study Design: Clinical adjacent segment pathology (CASP) is common after cervical disc surgery. A critical examination of 320 patients operated for cervical disc prolapse revealed that CASP can also occur in patients with congenital and degenerative fusion of cervical spine. This has not been studied in depth and there is a need for a practically applicable classification of CASP. Purpose: To develop a new classification scheme of CASP. Overview of Literature: A review of the literature did not reveal a practically applicable classification incorporating the occurrence of CASP in congenital and degenerative fusion cases. Methods: This was a retrospective analysis of 320 patients operated (509 disc spaces) on for cervical disc prolapse. Cases (n=316) were followed-up for 3–11 years. Random sampling of 220 patients with postoperative magnetic resonance imaging (MRI) in 165 cases was analyzed. Results: Six symptomatic CASP cases required resurgery (1.9%), eight cases involved MRI proven CASP with axial neck pain only and 13 patients were asymptomatic with radiological adjacent segment pathology (RASP). The frequency rate was 8.5% (27/316). Four cases of congenital or degenerative fusion of vertebra developed CASP requiring surgery. CASP is classified as primary or secondary follows. Primary A1 was congenital fusion of vertebra and primary A2 was degenerative fusion of the vertebra. Secondary, which was after cervical disc surgery, comprised B1 (RASP in asymptomatic patients), B2 (CASP in patients with axial neck pain), and B3 (CASP with myeloradiculopathy). B3 was subdivided into single-level CASP (B3a) and multiple-level CASP (B3b). Conclusions: Symptomatic CASP requiring resurgery is infrequent. CASP can occur in patients with congenital and degenerative fusion of the cervical spine. A new classification for CASP along with treatment strategy is proposed. Patients in Primary CASP and B3 CASP require resurgery while others require only observation.

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참고문헌 (26)

참고문헌 신청
Lawrence BD / 2012 / Predicting the risk of adjacent segment pathology in the cervical spine: a systematic review / Spine (Phila Pa 1976) 37(22 Suppl):S52~S64 google schola Harrod CC / 2012 / Adjacent segment pathology following cervical motionsparing procedures or devices compared with fusion surgery: a systematic review / Spine (Phila Pa 1976) 37(22 Suppl):S96~S112 google schola Hilibrand AS / 1999 / Radiculopathy and myelopathy at segments adjacent to the site of a previous anterior cervical arthrodesis / J Bone Joint Surg Am 81:519~528 google schola Ishihara H / 2004 / Adjacent segment disease after anterior cervical interbody fusion / Spine J 4:624~628 google schola Janssen ME / 2008 / Adjacent segment disease as a result of fusion in the cervical spine (C-ASD): prognostic factors / Evid Based Spine Surg 4:55~66 google schola

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