ArticleBMC musculoskeletal disorders2026
Does congenital cervical fusion predispose to adjacent segment degeneration? A retrospective cohort study.
Article in BMC musculoskeletal disorders, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundCongenital cervical fusion is associated with adjacent segment degeneration (ASD). The debate continues over whether ASD is a result of cervical fusion or a natural process of cervical aging.
objectiveThis study aims to determine if congenital cervical fusion is associated with an increased risk of ASD.
methodsThis research utilized a retrospective cohort study with a 1:2 case-control design to investigate 70 individuals diagnosed with Type I Klippel-Feil Syndrome (KFS) fused at C5-6. These subjects were compared against a control group comprising 140 age- and gender-matched individuals. Participants were stratified into three distinct age groups. T2-weighted MRI scans were utilized for measurement.
resultsKFS group shows significantly higher the Pfirrmann grade at C4-5 (younger group) and C6-7 (middle-age group). The severe degeneration proportion increases notably with age in both groups. The KFS group also presents with a higher biological age scale in the younger and middle-age groups. Dural sac compression index (DSCI) of KFS group is significant higher at C3-4, C4-5, and C6-7. Among the young group, the KFS group shows higher DSCI at C3-4 and C4-5. In the middle-age group, the KFS group shows higher DSCI at C2-3, C3-4, C4-5, and C6-7. In the older-age group, the KFS group has a higher DSCI at C6-7.
conclusions(1) Congenital cervical fusion not only accelerates degeneration in adjacent segments but also extends its impact to non-adjacent segments. (2) The fusion hastens the degeneration of the entire cervical spine. (3) The effects of these accelerated degeneration are especially pronounced during the early to mid-adulthood years.
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