ArticleEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2026
Adjacent segment degeneration after anterior cervical discectomy and fusion develops earlier and is more frequent in non-traumatic indications.
Article in European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 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
purposeTo compare the time to development of radiographic adjacent segment degeneration (ASDeg) following anterior cervical discectomy and fusion (ACDF) between patients treated for traumatic and non-traumatic indications.
methodsPatients were retrospectively analyzed and categorized into traumatic and non-traumatic groups. Patients underwent routine clinical and radiographic follow-up. Time to ASDeg was defined from the date of surgery to the date of ASDeg diagnosis or last follow-up. Kaplan-Meier analysis was used to estimate cumulative incidence, and group differences were assessed using Cox proportional hazards models with multivariable adjustment.
resultsEighty-two patients were included (traumatic: n = 30; non-traumatic: n = 52). Median follow-up was 7.4 years (IQR 5.7-10.4). The 8-year cumulative incidence of ASDeg was 30% (95% CI 11.5-44.6) in the traumatic group and 46.4% (95% CI 28.9-60.0) in the non-traumatic group. In Cox regression analysis, non-traumatic indication was associated with a higher hazard of ASDeg (crude HR 2.9, 95% CI 1.8-4.7; p < 0.001), which remained significant after adjustment (HR 2.2, 95% CI 1.1-4.5; p = 0.019).
conclusionNon-traumatic indications are associated with an earlier development and higher risk of radiographic adjacent segment degeneration following ACDF. These findings support the hypothesis that underlying degenerative processes contribute to the development of ASDeg beyond fusion-related biomechanical factors.
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