Assessment of adjacent segment degeneration in and between patients treated with anterior or posterior cervical simple discectomy.

AIM The authors compared the incidence of radiologically documented and/or symptomatic adjacent segment degeneration in and between patients who underwent anterior or posterior single-level, simple discectomy. MATERIAL AND METHODS 79 patients were clinically and radiologically examined for adjacent segment degeneration (ASD). The results were compared to evaluate which approach was predominant for adjacent segment disc degeneration. RESULTS ASD was found in 57 of a total of 79 patients. 24% of the patients demonstrated clinical and radiographic evidence and 48% of the patients demonstrated only radiographic evidence of ASD. Both anterior and posterior single level simple discectomy had similar rates for adjacent segment disease (p>0.05) . ASD was found to appear earlier in patients who had anterior cervical discectomy (4.78 vs 9.85 years, p:0.005). Symptomatic evidence of ASD was found to start earlier than radiological evidence of ASD (4.67 vs 7.63 years p:0.003). Radiographic evidence of adjacent segment degeneration was observed more commonly compared to symptomatic evidence of ASD (38 vs 19 patients p:0.002). CONCLUSION Although, radiographic and clinical evidence of ASD is inevitable for both simple cervical discectomy procedures, neither anterior nor posterior simple cervical discectomy is the predominant approach for causing ASD.