Efficacy and Safety of Anterior Cervical Discectomy and Fusion (ACDF) Through Mini-Incision and Posterior Laminoplasty (LAMP) For Treatment of Long-Level Cervical Spondylosis

Abstract Background: The efficacy and safety of anterior cervical discectomy and fusion (ACDF) through mini-incision and posterior laminoplasty for long-level cervical spondylosis were investigated. Method: From January 2018 to September 2019, clinical patients data with 3-4 segments (C3-7) cervical spondylotic radiculopathy, cervical spondylotic myelopathy, or mixed cervical spondylosis who received ACDF (42 cases) throughwith mini-incision or LAMP (36 cases) treatment were retrospectively collected and analyzed. The operative time, bleeding volume, incisive length, and hospital stay were recorded. Moreover, the intervertebral height, functional segment height, cervical lordosis, cervical hyperextension and hyperflexion range-of-motion (ROM) and ROM in all directions of the cervical spine before and after the operation were measured. Additionally, all relevant postoperative complications were also recorded. Then, the therapeutic effects of both surgical methods were investigated.Results: Patients in the ACDF group had less bleeding, shorter incision, and fewer hospitalization days than the LAMP group. Postoperative intervertebral height and functional segment height in the ACDF group were significantly higher than those before the operation, and postoperative functional segment height of the ACDF group was significantly higher than that of the LAMP group. Moreover, the postoperative cervical lordosis angle in the ACDF group was significantly larger than the LAMP group. There was no significant difference between preoperative and postoperative ROM in all directions of the cervical spine for the two groups.Conclusions: Both ACDF through mini-incision and LAMP are effective treatments for long-level cervical spondylosis. However, ACDF through mini-incision shows minor trauma, less bleeding, fast recovery, and it is beneficial for cervical lordosis reconstruction.

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Clinical study on the efficacy and safety of percutaneous endoscopic anterior cervical discectomy in the treatment of cervical disc herniation

International Orthopaedics ◽

10.1007/s00264-021-04982-x ◽

2021 ◽

Author(s):

Ma Haijun ◽

Zhang Haoping ◽

Zhou Honggang ◽

Zhao Xiaobing

Keyword(s):

Clinical Study ◽

Disc Herniation ◽

Anterior Cervical Discectomy ◽

Cervical Disc Herniation ◽

Cervical Disc ◽

Efficacy And Safety ◽

Cervical Discectomy

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P92. Adjacent disc pressure and facet force comparison for cervical spine arthroplasty with Spinal Kinetics, Prodisc-C, Prestige artificial discs, and anterior cervical discectomy and fusion

The Spine Journal ◽

10.1016/j.spinee.2005.05.307 ◽

2005 ◽

Vol 5 (4) ◽

pp. S154-S156 ◽

Cited By ~ 1

Author(s):

Daniel Kim ◽

Jesse Limm ◽

Max Lee ◽

Jon Park

Keyword(s):

Cervical Spine ◽

Anterior Cervical Discectomy ◽

Cervical Discectomy ◽

Adjacent Disc

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Cervical radiographic parameters in 1- and 2-level anterior cervical discectomy and fusion

Journal of Neurosurgery Spine ◽

10.3171/2016.2.spine151056 ◽

2016 ◽

Vol 25 (4) ◽

pp. 421-429 ◽

Cited By ~ 30

Author(s):

Christopher C. Gillis ◽

Megan C. Kaszuba ◽

Vincent C. Traynelis

Keyword(s):

Significant Positive Correlation ◽

Disc Height ◽

Anterior Cervical Discectomy ◽

Cervical Lordosis ◽

Cervical Discectomy ◽

Positive Correlation ◽

Cervical Deformity ◽

Radiographic Parameters ◽

Sagittal Parameters ◽

Segmental Lordosis

OBJECTIVE Anterior cervical discectomy and fusion (ACDF) is one of the most commonly performed spine procedures. It can be used to correct cervical kyphotic deformity, which is the most common cervical deformity, and is often performed using lordotic interbody devices. Worsening of the cervical sagittal parameters is associated with decreased health-related quality of life. The study hypothesis is that through the use of machined lordotic allografts in ACDF, segmental and overall cervical lordosis can be maintained or increased, which will have a positive impact on overall cervical sagittal alignment. METHODS Seventy-four cases of 1-level ACDF (ACDF1) and 2-level ACDF (ACDF2) (40 ACDF1 and 34 ACDF2 procedures) were retrospectively reviewed. Upright neutral lateral radiographs were assessed preoperatively and at 6 weeks and 1 year postoperatively. The measured radiographic parameters included focal lordosis, disc height, C2–7 lordosis, C1–7 lordosis, T-1 slope, and C2–7 sagittal vertical axis. Correlation coefficients were calculated to determine the relationships between these radiographic measurements. RESULTS The mean values were as follows: preoperative focal lordosis was 0.574°, disc height was 4.48 mm, C2–7 lordosis was 9.66°, C1–7 lordosis was 42.5°, cervical sagittal vertebral axis (SVA) was 26.9 mm, and the T-1 slope was 33.2°. Cervical segmental lordosis significantly increased by 6.31° at 6 weeks and 6.45° at 1 year. C2–7 lordosis significantly improved by 1 year with a mean improvement of 3.46°. There was a significant positive correlation between the improvement in segmental lordosis and overall cervical lordosis. Overall cervical lordosis was significantly negatively correlated with cervical SVA. Improved segmental lordosis was not correlated with cervical SVA in ACDF1 patients but was significantly negatively correlated in ACDF2 patients. There was also a significant positive correlation between the T-1 slope and cervical SVA. CONCLUSIONS In the study population, the improvement of focal lordosis was significantly correlated with an improvement in overall lordosis (C1–7 and C2–7), and overall lordosis as measured by the C2–7 Cobb angle was significantly negatively correlated with cervical SVA. Using lordotic cervical allografts, we successfully created and maintained significant improvement in cervical segmental lordosis at the 6-week and 1-year time points with values of 6.31° and 6.45°, respectively. ACDF is able to achieve statistically significant improvement in C2–7 cervical lordosis by the 1-year followup, with a mean improvement of 3.46°. Increasing the number of levels operated on resulted in improved cervical sagittal parameters. This establishes a baseline for further examination into the ability of multilevel ACDF to achieve cervical deformity correction through the intervertebral correction of lordosis.

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Overpowering the Previously Posterior Instrumented Cervical Spine With Cage-Assisted Anterior Cervical Discectomy and Fusion: A Cadaveric Study

Spine Deformity ◽

10.1016/j.jspd.2018.02.005 ◽

2018 ◽

Vol 6 (5) ◽

pp. 492-497

Author(s):

Philip Saville ◽

Rikesh A. Gandhi ◽

Harvey E. Smith ◽

Vincent Arlet

Keyword(s):

Cervical Spine ◽

Cadaveric Study ◽

Anterior Cervical Discectomy ◽

Cervical Discectomy

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Late deep cervical infection after anterior cervical discectomy and fusion: a case report and literature review

BMC Musculoskeletal Disorders ◽

10.1186/s12891-019-2783-x ◽

2019 ◽

Vol 20 (1) ◽

Author(s):

Ying-Chun Chen ◽

Lin Zhang ◽

Er-Nan Li ◽

Li-Xiang Ding ◽

Gen-Ai Zhang ◽

...

Keyword(s):

Cervical Spine ◽

Esophageal Perforation ◽

Radical Neck Dissection ◽

Titanium Implant ◽

Anterior Cervical Discectomy ◽

Antibiotic Administration ◽

Cervical Discectomy ◽

Cervical Infection ◽

Unstable Cervical Spine ◽

Degenerative Cervical Spine

Abstract Background Anterior cervical discectomy and fusion (ACDF) is often performed for the treatment of degenerative cervical spine. While this procedure is highly successful, 0.1–1.6% of early and late postoperative infection have been reported although the rate of late infection is very low. Case presentation Here, we report a case of 59-year-old male patient who developed deep cervical abscess 30 days after anterior cervical discectomy and titanium cage bone graft fusion (autologous bone) at C3/4 and C4/5. The patient did not have esophageal perforation. The abscess was managed through radical neck dissection approach with repated washing and removal of the titanium implant. Staphylococcus aureus was positively cultured from the abscess drainage, for which appropriate antibiotics including cefoxitin, vancomycin, levofloxacin, and cefoperazone were administered postoperatively. In addition, an external Hallo frame was used to support unstable cervical spine. The patient’s deep cervical infection was healed 3 months after debridement and antibiotic administration. His cervial spine was stablized 11 months after the surgery with support of external Hallo Frame. Conclusions This case suggested that deep cervical infection should be considered if a patient had history of ACDF even in the absence of esophageal perforation.

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