Maintaining range of motion after cervical discectomy does not prevent adjacent segment degeneration

Xiaoyu Yang*, Roland Donk, Mark P. Arts, Hisse Arnts, Joris Walraevens, Zhiwei Zhai, Bart Depreitere, Ronald H.M.A. Bartels, Carmen L.A. Vleggeert-Lankamp

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

BACKGROUND: Motion preservation prostheses were introduced to prevent adjacent disc degeneration (ASD) and to diminish neck disability in the postsurgical follow-up. However, it is still a controversial issue, and the relationship between range of motion (ROM) and ASD has not been studied. PURPOSE: To compare the correlation between ROM of the cervical spine and the presence of radiological ASD after anterior discectomy. Clinical outcome was also correlated to ROM and ASD. STUDY DESIGN: Retrospective cohort study. METHODS: In all, 253 patients who underwent anterior discectomy for cervical radiculopathy due to a herniated disc were analyzed for segmental and global cervical ROM and the presence of ASD both preoperatively, and 12 and 24 months postoperatively. Patients who were included in two randomized, double-blinded trials comparing anterior cervical discectomy with arthroplasty, anterior cervical discectomy with intervertebral cage, or anterior cervical discectomy without intervertebral cage for one level disc herniation were analyzed. ROM was defined by a custom-developed image analysis tool. ASD was defined by decrease in disc height and anterior osteophyte formation on X-rays. Clinical outcome was evaluated by means of the Neck Disability Index (NDI). RESULTS: Two years postoperatively, no correlation was demonstrated between ROM and ASD. The incidence of ASD was comparable in the three groups, being 34% at baseline, and 58% at 2-year follow-up. Likewise, ASD progression was comparable in the three treatment arms. No correlation was demonstrated between ROM and NDI or ASD and NDI. CONCLUSIONS: Since ROM is not correlated to ASD, and clinical outcome is not correlated to ROM either, the relevance of continued ROM at the target level seems absent.

Original languageEnglish
Pages (from-to)1816-1823
Number of pages8
JournalSpine Journal
Volume19
Issue number11
DOIs
Publication statusPublished - Nov 2019

Cite this

Yang, X., Donk, R., Arts, M. P., Arnts, H., Walraevens, J., Zhai, Z., ... Vleggeert-Lankamp, C. L. A. (2019). Maintaining range of motion after cervical discectomy does not prevent adjacent segment degeneration. Spine Journal, 19(11), 1816-1823. https://doi.org/10.1016/j.spinee.2019.07.011