caa a22 4500 606213872 CHVBK 20210128101049.0 cr unu---uuuuu 210128e20150601xx s 000 0 eng 10.1007/s00701-015-2388-6 doi (NATIONALLICENCE)springer-10.1007/s00701-015-2388-6 Subsidence as of 12months after single-level anterior cervical inter-body fusion. Is it related to clinical outcomes? [Elektronische Daten] [Chang-Hyun Lee, Ki-Jeong Kim, Seung-Jae Hyun, Jin Yeom, Tae-Ahn Jahng, Hyun-Jib Kim] Background: Subsidence is a frequent phenomenon in the interbody fusion process in patients with anterior cervical discectomy and fusion (ACDF). There is little evidence of whether subsidence in the cervical spine has any impact on clinical outcomes. Objectives: The purpose of this study is to investigate the correlation of subsidence and clinical outcomes after ACDF and to consider reasons subsidence might not cause unfavorable clinical outcomes. Methods: A total of 158 consecutive patients who underwent single-level ACDF were included. The patients were divided into a subsidence group (S-group) and a no subsidence group (N-group), with subsidence defined as a decrease by ≥3mm in total intervertebral height (TIH). We analyzed outcomes resulting from subsidence, particularly focusing on clinical outcomes and subsequent global and segmental kyphosis using a repeated measure analysis of variance (RM-ANOVA). Results: Subsidence occurred in 74 patients (46.8%) as of a 12-month follow-up. The S-group included 58.6% with a stand-alone cage for interbody fusion (p = 0.002). Clinical outcomes improved significantly over time (neck pain, RM-ANOVA: F(1.3, 205) = 125.1, p < 0.001; arm pain, RM-ANOVA: F(1.3, 203) = 290.8, p < 0.001). There was no significant difference in interaction with subsidence and clinical outcomes between the S- and N-group (neck pain, RM-ANOVA: F(2,153) = 1.04, p = 0.356, partial η2 = 0.229; arm pain, RM-ANOVA: F(2,153) = 0.56, p = 0.571, partial η2 = 0.142). Segmental angle increased in both groups over time and showed a statistically significant difference between the S- and N-groups (RM-ANOVA: F(3,143) = 6.148, p = 0.001, partial η2 = 0.959). Although, global cervical angle decreased generally and displayed no statically significant difference between the S- and N-group (RM-ANOVA: F(3,119) = 2.361, p = 0.075, partial η2 = 0.056). Conclusions: Radiographic subsidence after ACDF occurred in 46.8% patients as of 12months after the single-level ACDF. The lack of correlation between bad clinical outcome and radiographic subsidence may be due to segmental kyphosis, preserved posterior height, and maintaining the global cervical angle. Springer-Verlag Wien, 2015 Subsidence nationallicence Clinical outcome nationallicence Anterior nationallicence Cervical nationallicence Fusion nationallicence Lee Chang-Hyun Department of Neurosurgery, Konyang University Hospital, Konyang University College of Medicine, Daejeon, South Korea aut Kim Ki-Jeong Department of Neurosurgery, 300 Gumi-dong, Bundang-gu, 463-707, Seongnam, Gyeonggi, Republic of Korea aut Hyun Seung-Jae Department of Neurosurgery, 300 Gumi-dong, Bundang-gu, 463-707, Seongnam, Gyeonggi, Republic of Korea aut Yeom Jin Department of Orthopedic Surgery, Spine Center, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 300 Gumi-dong, Bundang-gu, 463-707, Seongnam, Gyeonggi, Republic of Korea aut Jahng Tae-Ahn Department of Neurosurgery, 300 Gumi-dong, Bundang-gu, 463-707, Seongnam, Gyeonggi, Republic of Korea aut Kim Hyun-Jib Department of Neurosurgery, 300 Gumi-dong, Bundang-gu, 463-707, Seongnam, Gyeonggi, Republic of Korea aut Acta Neurochirurgica Springer Vienna 157/6(2015-06-01), 1063-1068 0001-6268 157:6<1063 2015 157 701 https://doi.org/10.1007/s00701-015-2388-6 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00701-015-2388-6 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Lee Chang-Hyun Department of Neurosurgery, Konyang University Hospital, Konyang University College of Medicine, Daejeon, South Korea aut NATIONALLICENCE 700 1- Kim Ki-Jeong Department of Neurosurgery, 300 Gumi-dong, Bundang-gu, 463-707, Seongnam, Gyeonggi, Republic of Korea aut NATIONALLICENCE 700 1- Hyun Seung-Jae Department of Neurosurgery, 300 Gumi-dong, Bundang-gu, 463-707, Seongnam, Gyeonggi, Republic of Korea aut NATIONALLICENCE 700 1- Yeom Jin Department of Orthopedic Surgery, Spine Center, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 300 Gumi-dong, Bundang-gu, 463-707, Seongnam, Gyeonggi, Republic of Korea aut NATIONALLICENCE 700 1- Jahng Tae-Ahn Department of Neurosurgery, 300 Gumi-dong, Bundang-gu, 463-707, Seongnam, Gyeonggi, Republic of Korea aut NATIONALLICENCE 700 1- Kim Hyun-Jib Department of Neurosurgery, 300 Gumi-dong, Bundang-gu, 463-707, Seongnam, Gyeonggi, Republic of Korea aut NATIONALLICENCE 773 0- Acta Neurochirurgica Springer Vienna 157/6(2015-06-01), 1063-1068 0001-6268 157:6<1063 2015 157 701