邻椎病（adjacent segment disease ，ASD）是ACDF术后常见并发症之一。Wang指出ACDF术后邻椎病发生率约6.2%。Ahn等使用MRI进行ACDF术后3年邻椎病回顾性研究，指出50岁以上患者影像学上出现邻椎病变风险更高。
Bydon等的研究指出，ACDF手术节段和固定长度与邻椎病发生相关。
Xu 等的研究指出，第二次ACDF手术后邻椎病的发生率和病变进展速度明显高于首次手术。
Wang 等指出发育性管狭窄是单节段ACDF术后症状性邻椎病的危险因素。
Wei 等一项至少随访五年的研究指出，ACDF术后BMI高、骨质疏松严重和较大的C2-C7SVA邻椎病风险更高。
Broida 等的研究指出，年龄、先天性/发育性狭窄和术前较大的NDI（颈椎功能障碍指数）是邻椎病的危险因素。
Teo等的研究认为，矢状位失衡可能与单节段或双节段ACDF后的邻椎病发生有关。
ACDF术后发生症状性邻椎病该如何应对？
Wei等的研究认为，翻修手术能有效改善邻椎病患者临床症状和颈椎生理曲度。
O'Neill等的研究指出，对邻椎病行ACDF可显著改善患者疼痛、残疾指数和生活质量。
参考文献
[1]Wang F, Hou HT, Wang P, Zhang JT, Shen Y. Symptomatic adjacent segment disease after single-lever anterior cervical discectomy and fusion: Incidence and risk factors. Medicine (Baltimore). 2017 Nov;96(47):e8663.[2]Ahn SS, So WS, Ku MG, Kim SH, Kim DW, Lee BH. Radiologic Findings and Risk Factors of Adjacent Segment Degeneration after Anterior Cervical Discectomy and Fusion : A Retrospective Matched Cohort Study with 3-Year Follow-Up Using MRI. J Korean Neurosurg Soc. 2016 Mar;59(2):129-36.[3]Bydon M, Xu R, Macki M, De la Garza-Ramos R, Sciubba DM, Wolinsky JP, Witham TF, Gokaslan ZL, Bydon A. Adjacent segment disease after anterior cervical discectomy and fusion in a large series. Neurosurgery. 2014 Feb;74(2):139-46 discussion 146.[4]Wang F, Hou HT, Wang P, Zhang JT, Shen Y. Symptomatic adjacent segment disease after single-lever anterior cervical discectomy and fusion: Incidence and risk factors. Medicine (Baltimore). 2017 Nov;96(47):e8663.[5]Wei Z, Yang S, Zhang Y, Ye J, Chu TW. Prevalence and Risk Factors for Cervical Adjacent Segment Disease and Analysis of the Clinical Effect of Revision Surgery: A Minimum of 5 Years' Follow-Up. Global Spine J. 2023 Jul 8:21925682231185332.[6]Broida SE, Murakami K, Abedi A, Meisel HJ, Hsieh P, Wang J, Jain A, Buser Z, Yoon ST; AO Spine Knowledge Forum Degenerative. Clinical risk factors associated with the development of adjacent segment disease in patients undergoing ACDF: A systematic review. Spine J. 2023 Jan;23(1):146-156.[7]Teo SJ, Goh GS, Yeo W, Chen JL, Soh RCC. The Relationship Between Cervical Sagittal Balance and Adjacent Segment Disease After Three-level Anterior Cervical Discectomy and Fusion. Clin Spine Surg. 2021 Feb 5. doi: 10.1097/BSD.0000000000001135. Epub ahead of print.[8]Xu R, Bydon M, Macki M, De la Garza-Ramos R, Sciubba DM, Wolinsky JP, Witham TF, Gokaslan ZL, Bydon A. Adjacent segment disease after anterior cervical discectomy and fusion: clinical outcomes after first repeat surgery versus second repeat surgery. Spine (Phila Pa 1976). 2014 Jan 15;39(2):120-6.[9]O'Neill KR, Wilson RJ, Burns KM, Mioton LM, Wright BT, Adogwa O, McGirt MJ, Devin CJ. Anterior Cervical Discectomy and Fusion for Adjacent Segment Disease: Clinical Outcomes and Cost Utility of Surgical Intervention. Clin Spine Surg. 2016 Jul;29(6):234-41.
