Adjacent segment syndrome in patients after cervical spine spondylodesis

Aim of the paper. The article presents examples of the treatment of cervical discopathy from anterior approach using intervertebral implants. Two methods of treatment were compared: arthroplasty and spinal fusion. The evaluation was conducted on the basis of biomechanical and clinical studies. Material and methods. We analyzed the treatment of patients operated at the Department of Orthopedics and Rehabilitation in Zakopane in 2000-2004 (group I - spondylodesis method) and patients operated in 2005-2007 (Group II - by implantation of a mobile cervical disc prosthesis.) Resection of the degenerated disc and spinal fusion was performed on 24 patients (13 women, 11 men). Patient age was from 33 to 81 years (mean 52 years). Resection and implantation of movable disk implant was performed on 36 patients (29 women, 7 men). Total number of implanted disks was 47 (11 patients surgery was carried out on two levels, on the other - on one level). Disks were implanted on patients in age 18 to 66 (mean age 52 years). There were no complications during the operation in all cases. In group II, after the operation, in one case a temporary Horner’s syndrome occurred, one patient complained about shoulder pain. Results and conclusions. During the observation, in period immediately after surgery all patients achieved demission of previously reported symptoms. After two years from the operation, in group I, four patients reported the occurrence of similar symptoms as before surgery. In Group II (implant), two patients reported recurrence of pain. In case of one patient occurred calcification, along the anterior surface of cervical spine, partially limiting the mobility of operated segment. Results of treatment of cervical discopathy wit both methods were comparable in a short period of observation, later comes the problem of the adjacent segment syndrome.