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World J Orthop. Jul 18, 2013; 4(3): 112-113
Published online Jul 18, 2013. doi: 10.5312/wjo.v4.i3.112
Cervical adjacent segment pathology following fusion: Is it due to fusion?
Philip Rosenthal, Kee D Kim
Philip Rosenthal, Kee D Kim, Department of Neurological Surgery, UC Davis Health System, Sacramento, CA 95817, United States
Author contributions: Rosenthal P and Kim KD contributed to the writing and editing of the piece; Kim KD contributed the theory of the editorial.
Correspondence to: Kee D Kim, MD, Associate Professor, Chief of Spinal Neurosurgery, Department of Neurological Surgery, UC Davis Health System, 3860 Y Street, Suite 3740, Sacramento, CA 95817, United States. Kee.kim@ucdmc.ucdavis.edu
Telephone: +1-916-7347463 Fax: +1-916-7035368
Received: March 7, 2013
Revised: May 2, 2013
Accepted: May 18, 2013
Published online: July 18, 2013
Core Tip

Core tip: Cervical artificial disc surgery has brought the expectation of a lower rate of adjacent segment pathology. Randomized controlled trials (RCTs), currently have only two to four years follow ups and the results regarding adjacent segment surgery indicate only non statistically significant trends favoring the anterior cervical discectomy and arthroplasty (ACDA). Higher rates of radiographic adjacent level pathology, after anterior cervical diskectomy and fusion (ACDF) is already documented. We predict that as the RCT average age mid forty-year-old patients continue to their almost forty year expected longevity, adjacent level surgery rates after ACDF will also increase in comparison to the ACDA patients.