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2021, Number 3

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Ortho-tips 2021; 17 (3)

The relationship of sagittal balance and adjacent segment disease

Martínez SJA, Victoria BCJ, Monge RRL, Pérez PGL

Language: Spanish
References: 20
Page: 174-178
PDF size: 203.24 Kb.


ABSTRACT

Adjacent segment disease refers to the phenomenon of hypermobility of a level that comes immediately after a rigid segment that conditions a radiculopathy or myelopathy. Factors that predispose to this phenomenon are multiple, the more studied of which are loss of segmental mobility, sagittal balance alteration and multilevel surgery. There is evidence that after a cervical procedure, segmental and not global balance of the spine affect the outcome. In this clinical case study, we analyze the outcome after an ACDF and the impact on native dynamic properties after a change in SVA to 68 mm predisposing to an overload of the anterior column and adjacent segments that correlates with the actual literature of a poor outcome with an SVA over 40 mm. There is a lack of high quality literature that correlates adjacent segmental disease and its correlation with sagittal balance that is only based on radiological findings and not clinical, for that reason we decided to publish this case to add to the growing evidence of this problem and the importance of good surgical planning taking account the maintenance and/or correction of cervical sagittal balance in decompressive and fusion surgery for cervical myelopathy.


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