Cinematic in cervical progressive degenerative diseases

Introduction and aim: Despite whole clinical trials and clinical results ; there is stil ongoing debate on whether if neighbouring segmental degeneration is a part of the progressive process or depend on increased stress due to upper and lower segmental motion after postoperative fusion. The aim of this study, focusing on the long term follow up results, is to undertand whether the segmental degeneration is a part of this continuing process or depend on fusion induced incressed stress.Materials and methods: This study includes a total number of 60 patients, 26 female and 34 male with an age range of 23 to 68 who were operated due to cervical disc disease and cervical myelopathy between 2004-2006 in Inönü University Turgut Özal Medical Center. There are five groups where, Group I is those cases with one level simple cervical discectomy, Group II with one level segmental anterior fusion using autogen bone greft and plate and screw fixation, Group III with arthroplasty to protect segmental motion, Group IV with cervical spondylotic myelopathy operated by posterior stabilization and fusion using lateral mass screw and rod, and Group V with cervical spondylotic myelopathy treated with laminoplasty. Neutral, hyperflexion and hyperextantion cervical x-rays were performed for all patients.Disc height, flexibility, segmental angle and segmental flexibility were compaired for each patient.Results: On postoperative measurement for upper and lower neighbouring segmental disc height, only in grup II lower segmental disc height was decreased with statistical significance (p= 0.001). Flexibility degree measurement was significantly decreased in grup IV (p= 0.017). Segmental angle measurement in grup II disclosed upper (p=0.025) and lower (p=0.008) segmental angle degrees were significantly increased and in grup IV upper (p=0.046) and lower (p=0.046) ) segmental angle degrees were significantly decreased. Segmental flexibility measurement in grup II showed upper (p=0.049) and lower (p=0.013) segment values were significantly increased and statistically significant decreased in upper (p= 0.046) and lower (p= 0.043) values were remarked in group IV.Conclusion: According to our study results we think that, degeneration is a progressive process and fusion is increasing the degeneration speed and contributes this process. We believe that our results will contribute for future studies.Key words: Cervical dejenerative disease, cervical cinematic, neighbour segmental disease.