Abstract: Objective    To explore the surgical treatment strategy for adjacent segment disease (ASD) after anterior cervical discectomy and fusion of multi-segments.    Methods    From 2015 to 2019, 13 patients with ASD in our hospital were retrospectively analyzed. Eight patients were treated with anterior cervical Zero-P plate and 5 patients were treated with single-door laminoplasty. JOA, VAS, and NDI were noted to evaluate the clinical outcomes, and X-ray, CT, and MRI imaging were recorded and analyzed as well.   Results    All the patients were followed up for an average of 11.6 months (6~24 months). The JOA, VAS and NDI were significantly improved after both surgeries. In the anterior cervical operation group, the position of the internal fixation was good and no loosening of the plate screw was observed during follow-up. The average time of bone fusion was about 7.6 months. In patients who were treated with single-door laminoplasty, there were no complications such as C5 nerve root palsy, lamina re-closing and so on.   Conclusions   The selection of reoperation methods for ASD after multilevel anterior cervical fusion should follow the principle of individualization. For single-level ASD without severe posterior longitudinal ligament ossification, anterior decompression and fusion with the Zero-P system should be selected. For multi-levels ASD, the posterior single-door laminoplasty is preferred.

Key words: Cervical discectomy and fusion,  ,  , Adjacent segment disease,  ,  , Anterior approach, Posterior approach,  ,  ,  , Reoperation