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Purpose <p>To 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.</p> Methods <p>Patients 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.</p> Results <p>Eighty-two patients were included (traumatic: <i>n</i> = 30; non-traumatic: <i>n</i> = 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; <i>p</i> &lt; 0.001), which remained significant after adjustment (HR 2.2, 95% CI 1.1–4.5; <i>p</i> = 0.019).</p> Conclusion <p>Non-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.</p>

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Adjacent segment degeneration after anterior cervical discectomy and fusion develops earlier and is more frequent in non-traumatic indications

  • 期刊论文

  • 发表日期：

    2026年7月21日

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  • Valentino Latallade,
  • Matías Pereira Duarte,
  • Vanina Pagotto,
  • Gonzalo Kido,
  • Matías Petracchi,
  • Marcelo Gruenberg

摘要

Purpose

To 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.

Methods

Patients 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.

Results

Eighty-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).

Conclusion

Non-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.