Reintervention for Adjacent Segment Disease in a Cohort of Patients Operated of Anterior Corpectomy and Fusion for Degenerative Cervical Myelopathy

Introduction: To analyze reoperation rate with specific focus on adjacent segment disease (ASD) in a cohort of patients operated of anterior corpectomy and fusion (ACCF) for degenerative cervical myelopathy (DCM).

Methods: A prospectively collected database of 34 consecutive patients who underwent ACCF for DCM at Geneva University Hospital between 2019 and 2023 were analyzed regarding reintervention rate and postoperative complications.

Results: Overall, 79.4% of patients (27/34) underwent ACCF as first surgery, while 20.6% as revision. A PEEK cage was used in 14 cases (41.2%), and a titanium in 20 cases (58.8%). The mean preoperative mJOA was 13.4 ± 2.6 with a mean increase of 1.4 ± 2.5 at 1 year follow-up. The reoperation rate was 17.6% (6/34) with a mean time to second surgery of 228.7 ± 245.0 days over a mean follow-up of 18 ± 11.2 months. Median age at first surgery was 61.0 years [range: 52.5-69.5 years]. The main reason for reintervention was hardware loosening (11.8%, 4/34), only 1 patient (2.9%) for ASD, and 1 for persistent stenosis (2.9%). Altogether, 34 patients underwent 50 surgical procedures with a postoperative hematoma rate of 4.0% (2/50), and postoperative infection rate of 2.0% (1/50).

Conclusion : ACCF seems to be a safe and effective technique to treat patients with DCM with a low infection and postoperative hematoma rate. ASD seems to be a rare cause of reintervention in patients who undergo ACCF.