Multi- versus single-level anterior cervical discectomy and fusion: comparing sagittal alignment, early adjacent segment degeneration, and clinical outcomes

2018 ◽  
Vol 27 (11) ◽  
pp. 2745-2753 ◽  
Author(s):  
Bryce A. Basques ◽  
Philip K. Louie ◽  
Jeremy Mormol ◽  
Jannat M. Khan ◽  
Kamran Movassaghi ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Sagittal Alignment ◽  
Adjacent Segment Degeneration ◽  
Anterior Cervical Discectomy ◽  
Adjacent Segment ◽  
Cervical Discectomy ◽  
Single Level

Biomechanical Changes at Adjacent-Level Segments After Anterior Cervical Discectomy and Fusion

2003 ◽  
Author(s):  
R. N. Natarajan ◽  
G. B. J. Andersson ◽  
H. S. An
Keyword(s):  
Adjacent Segment Degeneration ◽  
Anterior Cervical Discectomy ◽  
Adjacent Segment ◽  
Exact Nature ◽  
Adjacent Level ◽  
Cervical Discectomy ◽  
Upper Cervical ◽  
Biomechanical Changes ◽  
Level Fusion ◽  
Element Study

It is well documented that there is significant motion in the unfused segments above and below a fused segment during anterior cervical discectomy and fusion but exact nature of this motion is not well known. The current finite element study showed that likelihood of adjacent segment degeneration is higher in a two level fusion than a one level fusion. Also, the analyses showed that two level fusion at upper cervical levels more likely to degenerate above and below than two level fusion at lower cervical levels.

Clinical and radiographic analysis of cervical disc arthroplasty compared with allograft fusion: a randomized controlled clinical trial

2007 ◽  
Vol 6 (3) ◽  
pp. 198-209 ◽  
Author(s):  
Praveen V. Mummaneni ◽  
J. Kenneth Burkus ◽  
Regis W. Haid ◽  
Vincent C. Traynelis ◽  
Thomas A. Zdeblick
Keyword(s):  
Anterior Cervical Discectomy ◽  
Cervical Disc ◽  
Cervical Disc Arthroplasty ◽  
Control Group ◽  
Adjacent Segment ◽  
Segmental Motion ◽  
Disc Arthroplasty ◽  
Cervical Discectomy ◽  
Single Level ◽  
The Prestige

Object The authors report the results of a prospective randomized multicenter study in which the results of cervical disc arthroplasty were compared with anterior cervical discectomy and fusion (ACDF) in patients treated for symptomatic single-level cervical degenerative disc disease (DDD). Methods Five hundred forty-one patients with single-level cervical DDD and radiculopathy were enrolled at 32 sites and randomly assigned to one of two treatment groups: 276 patients in the investigational group underwent anterior cervical discectomy and decompression and arthroplasty with the PRESTIGE ST Cervical Disc System (Medtronic Sofamor Danek); 265 patients in the control group underwent decompressive ACDF. Eighty percent of the arthroplasty-treated patients (223 of 276) and 75% of the control patients (198 of 265) completed clinical and radiographic follow-up examinations at routine intervals for 2 years after surgery. Analysis of all currently available postoperative 12- and 24-month data indicated a two-point greater improvement in the neck disability index score in the investigational group than the control group. The arthroplasty group also had a statistically significant higher rate of neurological success (p = 0.005) as well as a lower rate of secondary revision surgeries (p = 0.0277) and supplemental fixation (p = 0.0031). The mean improvement in the 36-Item Short Form Health Survey Physical Component Summary scores was greater in the investigational group at 12 and 24 months, as was relief of neck pain. The patients in the investigational group returned to work 16 days sooner than those in the control group, and the rate of adjacent-segment reoperation was significantly lower in the investigational group as well (p = 0.0492, log-rank test). The cervical disc implant maintained segmental sagittal angular motion averaging more than 7°. In the investigational group, there were no cases of implant failure or migration. Conclusions The PRESTIGE ST Cervical Disc System maintained physiological segmental motion at 24 months after implantation and was associated with improved neurological success, improved clinical outcomes, and a reduced rate of secondary surgeries compared with ACDF.

Cervical Spine Endplate Abnormalities and Association With Pain, Disability, and Adjacent Segment Degeneration After Anterior Cervical Discectomy and Fusion

Spine ◽  
2020 ◽  
Vol 45 (15) ◽  
pp. E917-E926
Author(s):  
Garrett K. Harada ◽  
Kevin Alter ◽  
Austin Q. Nguyen ◽  
Youping Tao ◽  
Philip K. Louie ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Adjacent Segment Degeneration ◽  
Anterior Cervical Discectomy ◽  
Adjacent Segment ◽  
Cervical Discectomy ◽  
Pain Disability

scholarly journals Comparison study of clinical outcomes and sagittal alignment improvement between anterior and posterior fusion techniques for multilevel cervical spondylotic myelopathy

2021 ◽  
Vol 29 (1) ◽  
pp. 230949902098817
Author(s):  
Hui Liu ◽  
Xiang Li ◽  
Jianru Wang ◽  
Zemin Li ◽  
Zihao Li ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Cervical Spondylotic Myelopathy ◽  
Sagittal Alignment ◽  
Vertical Axis ◽  
Anterior Cervical Discectomy ◽  
Sagittal Vertical Axis ◽  
Cervical Discectomy ◽  
Cervical Corpectomy ◽  
C7 Slope ◽  
Anterior Cervical Corpectomy

Purpose: To compare the sagittal alignment of different surgical approaches in patients with multiple levels cervical spondylotic myelopathy and explore the relationship between the cervical sagittal alignment and patient’s health relative quality of life. Method: A total of 97 multiple levels cervical spondylotic myelopathy patients who underwent surgery from January 2013 to January 2019 were collected in this study. Patients were divided into three groups: anterior cervical discectomy with fusion, anterior cervical corpectomy with fusion and laminectomy with fusion groups. Clinical outcomes and sagittal alignment parameters were compared preoperative and postoperative. Results: There were no significant differences in the average age and sex ratio among the groups. Sagittal parameters correlated to health relative quality of life were C7 slope, occipito-C2 angle, external auditory meatus tilt and cervical sagittal vertical axis. Both anterior cervical discectomy with fusion and anterior cervical corpectomy with fusion groups exhibited better sagittal alignment and clinical outcomes improvement postoperatively. Anterior cervical discectomy with fusion provided better clinical outcomes and the better improvement of cervical lordosis, C7 slope, occipito-C2 angle and cervical sagittal vertical axis compared with patients with Laminectomy with fusion. Conclusion: C7 slope, occipito-C2 angle, external auditory meatus tilt and cervical sagittal vertical axis are the most important cervical sagittal parameters correlated to clinical outcomes in patients with multilevels cervical spondylotic myelopathy; anterior cervical discectomy with fusion and anterior cervical corpectomy with fusion provides more efficient to restoration of cervical sagittal alignment.

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