Anterior Cervical Corpectomy and Fusion Accelerates Degenerative Disease at Adjacent Vertebral Segments
Why this work is in the frame
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Bibliographic record
Abstract
BACKGROUND: Anterior cervical corpectomy provides the most direct and thorough surgical approach for anterior decompression when spinal cord compression is found directly behind the vertebral body. However, anterior cervical fusion has been shown to be associated with the development of new degenerative changes at levels immediately adjacent to the fused segments. Th e incidence of adjacent segment disease (ASD) following anterior cervical corpectomy has not been widely reported. We set out to determine the incidence of clinical ASD following anterior cervical corpectomy. METHODS: We retrospectively reviewed all available medical charts and radiographic studies of all cases of anterior cervical corpectomy performed at the Barrow Neurological Institute over a 4-year period with a minimum 24-month follow-up. Factors assessed included the success of arthrodesis, the presence of degenerative changes on serial follow-up radiographs, and the development of new neurological symptoms. RESULTS: Seventy-six patients met the criteria for inclusion: 54 had undergone a 1-level corpectomy, 18 underwent a 2-level corpectomy, and 4 underwent a 3- or 4-level corpectomy. Arthrodesis was performed with either allograft or autograft and anterior cervical plating. All patients achieved successful fusion. Follow-up was available for a minimum of 2 years in all cases, with a mean length of 3.6 years. Sixteen patients (21%) eventually developed radiological and clinical evidence of degenerative changes at adjacent levels. In 10 of 11 patients who developed clinical symptoms within 2 years, the changes represented progression of pre-existing, asymptomatic degenerative disease. Five patients developed degenerative changes more than 5 years after surgery; these were all associated with an unrelated new insult to the cervical spine such as trauma. CONCLUSIONS: Anterior cervical corpectomy with fixation can accelerate degenerative changes identified preoperatively at adjacent, asymptomatic levels of the cervical spine. LEVEL OF EVIDENCE: Retrospective cohort study (level 2b).
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Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it