Use of Anterior Plates in Anterior Cervical Discectomy and Fusion After Traumatic Fracture Dislocations Lead to Early Adjacent-Level Degeneration

Abstract

Objectives Adjacent-level disc degeneration after anterior cervical discectomy and fusion (ACDF) is established in degenerative cervical disease. Plate-to-disc distance (PDD) 5 mm were in group A (n = 14) while those with PDD <5 mm were in group B (n = 36). The mean age was 38 and 43 years, respectively. There was significantly lower incidence of radiological evidence of disc degeneration in group A compared to group B (43.24% vs. 15.38%; p = 0.03). More patients had PDD <5 mm in cephalad adjacent discs compared to caudal adjacent discs (84.62% vs. 58.33%; p = 0.03). No significant difference was found comparing the proportion of caudal and cephalad adjacent discs that underwent degeneration (37.50% vs. 34.62%; p = 0.41). We further analysed the impact of different PDD cutoffs, varying from 2 mm to 6 mm, and found that a PDD of at least 4 mm significantly decreases the likelihood of adjacent disc degeneration (p = 0.03). Conculsion There was a significant increase in adjacent disc degeneration in patients undergoing ACDF when PDD was <5 mm. There was no difference in patient outcome between patients with two discs <5 mm away from the plate or patients with only one. A PDD of at least 4 mm decreased the likelihood of adjacent disc degeneration.