Background: Anterior cervical discectomy and fusion (ACDF), is commonly used for treatment of degenerative cervical spondylotic radiculopathy and myelopathy, and satisfactory out-comes have been reported in many studies. However, subsequent disc degeneration at levels adjacent to the fusion remains an important problem. Aim of the Work:To perform a systematic review and metaanalysis to evaluate incidence, risk factors, and impact of radiographic and clinical postoperative adjacent segment degeneration (ASD) following anterior decompression and instrumented fusion.

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