A comparative study of surgical outcomes between anterior cervical discectomy with fusion and selective laminoplasty for cervical spondylotic myelopathy

2021 ◽  
Author(s):  
Kenichiro Sakai ◽  
Toshitaka Yoshii ◽  
Yoshiyasu Arai ◽  
Takashi Hirai ◽  
Ichiro Torigoe ◽  
...  
Keyword(s):  
Comparative Study ◽  
Surgical Outcomes ◽  
Cervical Spondylotic Myelopathy ◽  
Anterior Cervical Discectomy ◽  
Cervical Discectomy

Evaluation of Results of Anterior Cervical Discectomy Fusion (ACDF) by Cervical Cage with Bone Graft for the Treatment of Single Level Cervical Spondylotic Myelopathy

2019 ◽  
Vol 2 (2) ◽  
pp. 12-18
Author(s):  
R Chowdhury ◽  
D Mishra ◽  
S Batajoo ◽  
M Shrestha
Keyword(s):  
Bone Graft ◽  
Clinical Examination ◽  
Cervical Spondylotic Myelopathy ◽  
Anterior Cervical Discectomy ◽  
Female Ratio ◽  
Cervical Discectomy ◽  
Single Level ◽  
Male Female Ratio ◽  
History Of ◽  
Anterior Cervical Discectomy Fusion

Background: Cervical spondylotic myelopathy (CSM) is a common spinal cord disorder that develops in elderly people. Anterior cervical decompression and fusion (ACDF) is an effective and reliable procedure for the treatment of CSM. Objective: To find out the results of ACDF by cervical cage with bone graft for the treatment of single level cervical spondylotic myelopathy. Methods: This prospective observational study was conducted in the Department of Orthopedics, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, over a period of two years from March 2015 to August 2017. Forty patients with cervical spondylotic myelopathy were diagnosed on the basis of presenting complains, clinical examination and investigations and were enrolled in this study. The history of the patients was collected, clinical examination was done and relevant investigations were done for each patient. In this study, Nurick grading and VAS scale were used for evaluation of the result. Result: Male gender was predominant in this study; male-female ratio was 2.63:1. Mean age of the patients was 45.9 ± 9.1 years within the range of 30-65 years. Both sides were affected in 14 (35.0%) cases, only right side was affected in 15 (37.5%) cases and only left side was affected in 11 (27.5%) cases. Involved disc spaces were C3/4 (10.0%), C4/5 (22.5%), C5/6 (42.5%) and C6/7 (25.0%). Transientdysphagia was observed in 2 (5.0%), transient para paresis in 1 (2.5.0%), wound infection in 1(2.5.0%) case and damage to the dura was observed in 1 (2.5.0%) case. Signs of fusion were observed in 10 (25.0%) cases after 3 months, 30 (75.0%) cases after 6 months and in all patients after 12months. The result was found to be excellent in 35 (87.5%) and good in 5 (12.5%) cases. Conclusion: Anterior cervical discectomy and fusion by cervical cage with bone graft is an effective procedure for management of CSM.

scholarly journals Impact of body mass index on surgical outcomes, narcotics consumption, and hospital costs following anterior cervical discectomy and fusion

2018 ◽  
Vol 28 (2) ◽  
pp. 160-166 ◽  
Author(s):  
Ankur S. Narain ◽  
Fady Y. Hijji ◽  
Brittany E. Haws ◽  
Krishna T. Kudaravalli ◽  
Kelly H. Yom ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Surgical Outcomes ◽  
Hospital Costs ◽  
Normal Weight ◽  
Anterior Cervical Discectomy ◽  
Postoperative Outcomes ◽  
Cervical Discectomy ◽  
Chi Square Analysis ◽  
Reoperation Rates

OBJECTIVEGiven the increasing prevalence of obesity, more patients with a high body mass index (BMI) will require surgical treatment for degenerative spinal disease. In previous investigations of lumbar spine pathology, obesity has been associated with worsened postoperative outcomes and increased costs. However, few studies have examined the association between BMI and postoperative outcomes following anterior cervical discectomy and fusion (ACDF) procedures. Thus, the purpose of this study was to compare surgical outcomes, postoperative narcotics consumption, complications, and hospital costs among BMI stratifications for patients who have undergone primary 1- to 2-level ACDF procedures.METHODSThe authors retrospectively reviewed a prospectively maintained surgical database of patients who had undergone primary 1- to 2-level ACDF for degenerative spinal pathology between 2008 and 2015. Patients were stratified by BMI as follows: normal weight (< 25.0 kg/m2), overweight (25.0–29.9 kg/m2), obese I (30.0–34.9 kg/m2), or obese II–III (≥ 35.0 kg/m2). Differences in patient demographics and preoperative characteristics were compared across the BMI cohorts using 1-way ANOVA or chi-square analysis. Multivariate linear or Poisson regression with robust error variance was used to determine the presence of an association between BMI category and narcotics utilization, improvement in visual analog scale (VAS) scores, incidence of complications, arthrodesis rates, reoperation rates, and hospital costs. Regression analyses were controlled for preoperative demographic and procedural characteristics.RESULTSTwo hundred seventy-seven patients were included in the analysis, of whom 20.9% (n = 58) were normal weight, 37.5% (n = 104) were overweight, 24.9% (n = 69) were obese I, and 16.6% (n = 46) were obese II–III. A higher BMI was associated with an older age (p = 0.049) and increased comorbidity burden (p = 0.001). No differences in sex, smoking status, insurance type, diagnosis, presence of neuropathy, or preoperative VAS pain scores were found among the BMI cohorts (p > 0.05). No significant differences were found among these cohorts as regards operative time, intraoperative blood loss, length of hospital stay, and number of operative levels (p > 0.05). Additionally, no significant differences in postoperative narcotics consumption, VAS score improvement, complication rates, arthrodesis rates, reoperation rates, or total direct costs existed across BMI stratifications (p > 0.05).CONCLUSIONSPatients with a higher BMI demonstrated surgical outcomes, narcotics consumption, and hospital costs comparable to those of patients with a lower BMI. Thus, ACDF procedures are both safe and effective for all patients across the entire BMI spectrum. Patients should be counseled to expect similar rates of postoperative complications and eventual clinical improvement regardless of their BMI.

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