Evaluation of clinical profile, radiological and functional outcome following anterior cervical discectomy and fusion for cervical compressive myelopathy

Background: Symptomatic cervical disc prolapse is best managed with anterior cervical discectomy with or without fusion. We studied the clinical, radiological and surgical profile with postoperative outcome of the patients undergoing anterior cervical discectomy and fusion (ACDF) for cervical compressive myelopathy at one level.Methods: In this retrospective study, data was collected from patients who underwent ACDF for cervical compressive myelopathy in our hospital between 2016 and 2019. Clinical, radiological profile with surgical outcome were studied.Results: A total of 283 patients were recruited. They could be followed up for a period of at least 6 months and so were recruited for the study. Out of these 283 patients (201 males; 82 females; mean age, 48.4 years, range, 22 years to 83 years), magnetic resonance imaging (MRI) cervical spine without contrast and x-ray cervical spine was available for all the patients. Nape of neck pain was the most common presenting symptom followed by tingling sensation in all four limbs and trunk. Average time taken for surgery was 2 hours 10 minutes with an average blood loss of 50 ml. Mean follow up duration was 2.7 years (range 6 months to 4 years).Conclusions: ACDF is the treatment of choice for the patients with clinical and radiological evidence of cervical cord compression. The techniques is associated with minimal blood loss and exceptionally good surgical outcome. Following discectomy, putting an autologous graft or titanium cage improves the spine stability and maintains the cervical lordosis.

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Comparative study of anterior cervical discectomy and fusion by anterior cervical plate and stand-alone cervical cage

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20203540 ◽

2020 ◽

Vol 6 (5) ◽

pp. 888

Author(s):

Ansari Muqtadeer Abdul Aziz ◽

Venktesh Dattatray Sonkawade ◽

Ansari Ishtyaque Abdul Aziz ◽

Nair Pradeepkumar Sasidharan

Keyword(s):

Cervical Spine ◽

Intraoperative Complications ◽

Anterior Cervical Discectomy ◽

Research Centre ◽

Cervical Disc ◽

Cervical Discectomy ◽

Single Level ◽

Incision Size ◽

Cervical Plate ◽

Anterior Cervical Plate

Background: Anterior cervical discectomy (ACD) was used for management of degenerative cervical disc disorders (DCDD) in previous days. Further research and developments in management of DCDD led to evolution of standard and widely used operative technique as anterior cervical discectomy and fusion (ACDF) by either anterior cervical plate (ACDF-ACP) with bone grafting or stand-alone cage (ACDF-SAC). There is less data available in literature regarding when and where to use ACDF-ACP and ACDF-SAC.Methods: The study was conducted on 20 patients operated in Government Medical College and Hospital and Pacific Hospital and Research Centre, Aurangabad from June 2018 to March 2020. These patients divided into group A - 10 patients, operated by ACDF-SAC which are further divided as group Aa - 6 patients - operated for single level ACDF-SAC and group Ab - 4 patients - operated for two level ACDF-SAC, group B - 10 patients, operated by ACDF-ACP which are further divided as group Ba - 5 patients - operated for single level ACDF-ACP and group Bb - 5 patients - operated for two level ACDF-ACP. Patients evaluated preoperatively and postoperatively using X-ray cervical spine anteroposterior (AP) and lateral views, MRI cervical spine, visual analogue scale (VAS) for pain, Robinson’s criteria and Cobb’s angle.Results: In our study we found, ACDF-SAC has small incision size, less intraoperative time, easy to carry out for surgeons, less intraoperative complications and better clinical outcome as compared to ACDF-ACP. Whereas only radiological results were better in ACDF-ACP than ACDF-SAC.Conclusions: ACDF-SAC is superior to ACDF-ACP for appropriately selected patients and in well experienced hands.

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Cervical spine kinematics after anterior cervical discectomy with or without implantation of a mobile cervical disc prosthesis; an RCT

BMC Musculoskeletal Disorders ◽

10.1186/s12891-015-0479-4 ◽

2015 ◽

Vol 16 (1) ◽

Cited By ~ 2

Author(s):

Toon FM Boselie ◽

Henk van Mameren ◽

Rob A de Bie ◽

Henk van Santbrink

Keyword(s):

Cervical Spine ◽

Anterior Cervical Discectomy ◽

Cervical Disc ◽

Disc Prosthesis ◽

Cervical Discectomy ◽

Spine Kinematics ◽

Cervical Disc Prosthesis

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A comparison study between hybrid surgery and anterior cervical discectomy and fusion for the treatment of multilevel cervical spondylosis

The Bone & Joint Journal ◽

10.1302/0301-620x.102b8.bjj-2019-1666.r1 ◽

2020 ◽

Vol 102-B (8) ◽

pp. 981-996

Author(s):

Yong-Dong Yang ◽

He Zhao ◽

Yi Chai ◽

Ding-Yan Zhao ◽

Li-Jun Duan ◽

...

Keyword(s):

Blood Loss ◽

Japanese Orthopaedic Association ◽

Anterior Cervical Discectomy ◽

Sensitivity Analyses ◽

Cervical Disc ◽

Symptom Improvement ◽

Adjacent Segment ◽

Hybrid Surgery ◽

Cervical Discectomy ◽

Hospitalization Time

Aims Whether to perform hybrid surgery (HS) in contrast to anterior cervical discectomy and fusion (ACDF) when treating patients with multilevel cervical disc degeneration remains a controversial subject. To resolve this we have undertaken a meta-analysis comparing the outcomes from HS with ACDF in this condition. Methods Seven databases were searched for studies of HS and ACDF from inception of the study to 1 September 2019. Both random-effects and fixed-effects models were used to evaluate the overall effect of the C2-C7 range of motion (ROM), ROM of superior/inferior adjacent levels, adjacent segment degeneration (ASD), heterotopic ossification (HO), complications, neck disability index (NDI) score, visual analogue scale (VAS) score, Japanese Orthopaedic Association (JOA) score, Odom’s criteria, blood loss, and operating and hospitalization time. To obtain more credible results contour-enhanced funnel plots, Egger’s and Begg’s tests, meta-regression, and sensitivity analyses were performed. Results In total, 17 studies involving 861 patients were included in the analysis. HS was found to be superior to ACDF in maintaining C2-C7 ROM and ROM of superior/inferior adjacent levels, but HS did not reduce the incidence of associated level ASD. Also, HS did not cause a higher rate of HO than ACDF. The frequency of complications was similar between the two techniques. HS failed to achieve more favourable outcomes than ACDF using the NDI, VAS, JOA, and Odom’s scores. HS did not show any more advantages in operating or hospitalization time but did show reduction in blood loss. Conclusion Although HS maintained cervical kinetics, it failed to reduce the incidence of ASD. This finding differs from previous reports. Moreover, patients did not show more benefits from HS with respect to symptom improvement, prevention of complications, and clinical outcomes. Cite this article: Bone Joint J 2020;102-B(8):981–996.

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