scholarly journals Outcome of Anterior Cervical Discectomy and Fusion for Cervical Spondylotic Myelopathy

2019 ◽  
Vol 9 (2) ◽  
pp. 133-137
Author(s):  
Apel Chandra Saha ◽  
Md Hasan Masud
Keyword(s):  
Cervical Spondylotic Myelopathy ◽  
Cervical Spinal Cord ◽  
Donor Site ◽  
Fusion Rate ◽  
Donor Site Morbidity ◽  
Anterior Cervical Discectomy ◽  
Common Procedure ◽  
Cervical Discectomy ◽  
Operative Complications ◽  
Before And After

Background: Cervical spondylotic myelopathy (CSM) is a progressive degenerative disease and the most common cause of cervical spinal cord dysfunction (SCD) in older patients. Anterior cervical discectomy andfusion (ACDF) is a common procedure for patients with severe neurological deterioration. The goals of this study were to evaluate the clinical and functional outcome, radiological fusion and operative complications in case of CSM who underwent ACDF by autogeneous-tricortical bone graft and stabilized with plate and screws. Methods: This prospective interventional study was carried out at National Institute of Traumatology and Orthopaedic Rehabilitation ( NITOR) and different private hospitals in Dhaka from January 2012 to December 2014. Within this period total 12 CSM patients were included as study sample. All were surgically treated by ACDF and stabilized by plate and screws. All patients were clinically and radiologically evaluated before and after surgery. Results: Single level ACDF by autograft and stabilization by plate and screws was done in 10 (83.33%) patients and 2 (16.67%) patients had two level fusion. The mean follow up period was 12 months. The satisfactory result was found in 10 (83.33%) patients. Post-operative complications were donor site morbidity in2 (16.67%) patients and transient dysphagia in 1 (8.33%) patient. The fusion rate was 100% in this series. Conclusion: ACDF with anterior plating for CSM is a safe and effective procedure. It results in highest fusion, least complication and relatively lower cost. Birdem Med J 2019; 9(2): 133-137

scholarly journals Anterior cervical discectomy and fusion with polyetheretherketone cages in the management of single and double level cervical spondylotic myelopathy-our experiences of 80 cases

KYAMC Journal ◽  
2018 ◽  
Vol 9 (1) ◽  
pp. 32-34
Author(s):  
Md Anowarul Islam ◽  
Mohd Alamgir Hossain ◽  
Ahmed Asif Iqbal ◽  
Md Qumruzzaman Parvez ◽  
Md Ahsanuzzaman ◽  
...  
Keyword(s):  
Clinical Outcome ◽  
Donor Site ◽  
Fusion Rate ◽  
Anterior Cervical Discectomy ◽  
Cervical Discectomy ◽  
X Ray ◽  
Arm Pain ◽  
Operative Complications ◽  
Medical University

Background: Anterior cervical discectomy with fusion (ACDF) is challenging with respect to both patient selection and choice of surgical procedure.Objectives: The aim of this study was to evaluate the clinical outcome of anterior cervical discectomy and fusion with an artificial cage made of polyetheretherketoneMaterials & Methods: From January 2012 to January 2017, 80 consecutive patients referred to the Department of spine surgery, Bangabandhu Shekh Mujib Medical University were recruited for the study. Postoperative Clinical outcome assessed with Nurick scale for myelopathy, Odom's criteria for functional outcome and Visual Analogue Scale (VAS) for both neck and arm pain. Radiological fusion was assessed by X-ray. Operative complications were reported.Results: 36 patients were operated for one level discectomy and fusion with PEEK cages and 44 patients for two levels. There were 48 (60%) males and 32 (40%) females. The age of the patients ranged from 30-72 years, a mean ± SD 45 ± 8.34. At the 2 years clinical follow-up, there were significant post operative improvements of Nurick scale, and VAS comparative to preoperative record. According to Odom's criteria, 72/80 patients (90%) were graded excellent-good.Conclusion: Anterior cervical discectomy and fusion with polyetheretherketone (PEEK) cage is an effective treatment of cervical myelopathy having higher fusion rate and lack of donor site morbidity.KYAMC Journal Vol. 9, No.-1, April 2018, Page 32-34

scholarly journals Outcome of Anterior Cervical Decompression and Fusion for Cervical Spondylotic Myelopathy

2020 ◽  
Vol 14 (2) ◽  
pp. 127-129
Author(s):  
Md Salim Ur Rahman ◽  
Mohammad Russel ◽  
Mohd Rezaul Karim
Keyword(s):  
Spinal Cord ◽  
Cervical Spondylotic Myelopathy ◽  
Armed Forces ◽  
Fusion Rate ◽  
Anterior Cervical Discectomy ◽  
Military Hospital ◽  
Common Procedure ◽  
Cervical Discectomy ◽  
Anterior Cervical Decompression ◽  
Satisfactory Outcome

Introduction: Anterior cervical discectomy and fusion (ACDF) is a common procedure for a patient with progressive spinal cord compression and severe neurological deterioration causing major disability. Surgery in anterior approach involves removal of osteophyte and disc materials for decompression of spinal cord with addition to the interposition of autogenous tricortical bone graft and stabilization by plate and screw. Objectives: To assess the clinical outcome, complications of anterior cervical decompression and fusion for cervical spondylotic myelopathy. Materials and Methods: This prospective interventional study was carried out in the Department of Orthopaedic Surgery, Combined Military Hospital, Dhaka from January 2015 to May 2017. Total of 24 cases of cervical spondylotic myelopathy was enrolled as a study sample. All were treated by an anterior cervical discectomy, fusion and stabilization by plate and screw. All patients were clinically and radiographically evaluated before and after surgery. Results: In the majority (62.5%) patients, the level of involvement was in C5/C6 and 92.8% had a satisfactory outcome. In 4.1% of cases, early complication like superficial wound infection was noted. Late complications were persistence of pain, numbness present in 7.2% cases. The fusion rate was 100% in this series. Conclusion: Anterior cervical decompression and fusion for cervical spondylotic myelopathy is a safe and effective procedure. It is associated with the highest fusion, least complications and relatively lower cost. Journal of Armed Forces Medical College Bangladesh Vol.14 (2) 2018: 127-129

Donor Site Morbidity After Anterior Iliac Crest Bone Harvest for Single-Level Anterior Cervical Discectomy and Fusion

Spine ◽  
2003 ◽  
Vol 28 (2) ◽  
pp. 134-139 ◽  
Author(s):  
Jeff S. Silber ◽  
D. Greg Anderson ◽  
Scott D. Daffner ◽  
Brian T. Brislin ◽  
J. Martin Leland ◽  
...  
Keyword(s):  
Iliac Crest ◽  
Donor Site ◽  
Donor Site Morbidity ◽  
Anterior Cervical Discectomy ◽  
Cervical Discectomy ◽  
Single Level

scholarly journals Comparison between anterior cervical discectomy with fusion by polyetheretherketone cages and tricortical iliac-crest graft for the treatment of cervical prolapsed intervertebral disc

2016 ◽  
Vol 9 (3) ◽  
pp. 169
Author(s):  
Md. Anowarul Islam ◽  
Md. Masud Rana ◽  
Md. Fahad Goni ◽  
Md. Naimur Rahman
Keyword(s):  
Iliac Crest ◽  
Donor Site ◽  
Fusion Rate ◽  
Anterior Cervical Discectomy ◽  
Peek Cage ◽  
Iliac Crest Graft ◽  
Cervical Discectomy ◽  
Arm Pain ◽  
Significant Difference ◽  
Cage Group

<p>Anterior cervical discectomy with fusion (ACDF) is challenging in relation to the choice of surgical procedure.  The objective of this study was to evaluate the clinical outcome of ACDF with  tricor-tical iliac crest graft (ICG) and plate screw in comparision to fusion with  polyetheretherketone (PEEK) cages filled with autologous iliac crest graft. Forty patients (males 24; females 16 with mean age 45 ± 8.3 years) were randomly divided into two treatment groups (PEEK cage and ICG). Clinical assessment was done using Nurick scale for myelopathy, Odom's criteria for functional outcome and Visual Analogue Scale (VAS) for both neck and arm pain. Seventeen patients were operated for single-level discectomy and fusion by either PEEK cages or ICG. Another 23 patients were operated for two-levels. There were significant postoperative improvements of  Nurick scale and VAS during follow-up (after 2 years). According to Odom criteria, 18 patients (90%) were graded excellent in the PEEK cage group compared to 16 patients (85%) in the group with ICG group (statistically not significant). A significant difference (p&lt;0.02) was found in VAS for arm pain after 24 months with less pain in the cage group. Fusion occurred in 17 patients (85%) of the PEEK cage group and 18 patient (90%) of the ICG group. In conclusion, the PEEK cage is superior for fusion rate but the ICG is lack of donor site morbidity.</p><p> </p>

scholarly journals Preliminary outcomes of allograft and hydroxyapatite as substitutes for autograft in anterior cervical discectomy and fusion with self-locking standalone cages

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Changsheng Yang ◽  
Wentao Zhuo ◽  
Qingchu Li ◽  
Caiqiang Huang ◽  
Huibo Yan ◽  
...  
Keyword(s):  
Clinical Efficacy ◽  
Donor Site ◽  
Fusion Rate ◽  
Iliac Bone ◽  
Anterior Cervical Discectomy ◽  
Allogeneic Bone ◽  
Cervical Discectomy ◽  
Cage Subsidence ◽  
Group A ◽  
Group B

Abstract Purpose To investigate the efficacy and safety of allograft and hydroxyapatite (HA) as substitutes for autograft in anterior cervical discectomy and fusion (ACDF). Methods In this study, 49 patients (80 segments) treated with ACDF were included and allocated into three groups [group A, autogenous iliac bone, n = 18; group B, allogeneic bone, n = 16; group C, HA, n = 15]. The clinical efficacy and fusion status were compared among each group. Complications were recorded in detail, and the Bazaz classification and Voice Handicap Index-10 (VHI-10) were used to detect dysphagia and dysphonia. Results Patients exhibited similar clinical efficacy among the groups during the final follow-up. All patients in groups A and B achieved fusion compared to only 73.3% of patients in group C. Groups A and B had similar fusion score, both of which greater than that of group C. No cage subsidence was observed in group A; however, 6.3% of patients in group B and 53.3% in group C had cage subsidence. Two patients in group A (11.1%) had persistent pain at the donor site. One patient in group B had dysphagia and dysphonia (6.3%), while one patient in group C had dysphonia (6.7%). Conclusion In ACDF, the autogenous iliac bone was the most ideal bone graft. The allogeneic bone was an acceptable substitute but risked cage subsidence and dysphagia. HA had a much lower fusion rate and a high risk of cage subsidence. Better substitutes should be further explored for ACDF.

scholarly journals In Spondylotic Cervical Myelopathy Anterior Cervical Discectomy and Fusion by Peek Cage Without Plate Reinforcement is a Standard Method of Treatment

2017 ◽  
Vol 25 (2) ◽  
pp. 110-114
Author(s):  
Md Anowarul Islam ◽  
Qamruzzaman Parvez ◽  
SK Sarker ◽  
Md Fahad Goni ◽  
Md Masud Rana
Keyword(s):  
Clinical Outcome ◽  
Cervical Myelopathy ◽  
Donor Site ◽  
Fusion Rate ◽  
Anterior Cervical Discectomy ◽  
Peek Cage ◽  
Cervical Discectomy ◽  
Medical College ◽  
Arm Pain ◽  
Medical University

Background: Anterior cervical discectomy with fusion (ACDF) is challenging with respect to both patient selection and choice of surgical procedure.Objective: The aim of this study was to evaluate the clinical outcome of anterior cervical discectomy and fusion with an artificial cage made of polyetheretherketone .Patients and Methods: From January 2012 to January 2016, 40 consecutive patients referred to the Department of spine surgery, Bangabandhu Shekh Mujib Medical University were recruited for the study.Postoperative Clinical outcome assessd with Nurick scale for myelopathy, Odom’s criteria for functional outcome and Visual Analogue Scale (VAS) for both neck and arm pain. Radiological fusion was assessed by X-ray. Operative complications were reported.Results: 18 patients were operated for one level discectomy and fusion with PEEK cages and 22 patients for two levels. There were 24 (60%) males and 16 (40%) females. The age of the patients ranged from 30-72 years, a mean ± SD 45±8.34. At the 2 years clinical follow-up, there were significant post operative improvements of Nurick scale, and VAS comparative to preoperative record. According to Odom’s criteria, 36/40 patients (90%) were graded excellentgood.Conclusion: Anterior cervical discectomy and fusion with polyetheretherketone (PEEK) cage is an effective treatment of cervical myelopathy having higher fusion rate and lack of donor site morbidity.J Dhaka Medical College, Vol. 25, No.2, October, 2016, Page 110-114

Cervical surgical techniques for the treatment of cervical spondylotic myelopathy

2009 ◽  
Vol 11 (2) ◽  
pp. 130-141 ◽  
Author(s):  
Praveen V. Mummaneni ◽  
Michael G. Kaiser ◽  
Paul G. Matz ◽  
Paul A. Anderson ◽  
Michael W. Groff ◽  
...  
Keyword(s):  
Cervical Spondylotic Myelopathy ◽  
Surgical Techniques ◽  
Fusion Rate ◽  
Anterior Cervical Discectomy ◽  
Functional Improvement ◽  
Class Iii ◽  
Cervical Discectomy ◽  
Cervical Spine Surgery ◽  
Deterioration Rate ◽  
Near Term

Object The objective of this systematic review was to use evidence-based medicine to compare the efficacy of different surgical techniques for the treatment of cervical spondylotic myelopathy (CSM). Methods The National Library of Medicine and Cochrane Database were queried using MeSH headings and keywords relevant to anterior and posterior cervical spine surgery and CSM. The guidelines group assembled an evidentiary table summarizing the quality of evidence (Classes I–III). The group formulated recommendations that contained the degree of strength based on the Scottish Intercollegiate Guidelines network. Validation was done through peer review by the Joint Guidelines Committee of the American Association of Neurological Surgeons/Congress of Neurological Surgeons. Results A variety of techniques have improved functional outcome after surgical treatment for CSM, including anterior cervical discectomy with fusion (ACDF), anterior cervical corpectomy with fusion (ACCF), laminoplasty, laminectomy, and laminectomy with fusion (Class III). Anterior cervical discectomy with fusion and ACCF appear to yield similar results in multilevel spine decompression for lesions at the disc level. The use of anterior plating allows for equivalent fusion rates between these techniques (Class III). If anterior fixation is not used, ACCF may provide a higher fusion rate than multilevel ACDF but also a higher graft failure rate than multilevel ACDF (Class III). Anterior cervical discectomy with fusion, ACCF, laminectomy, laminoplasty, and laminectomy with arthrodesis all provide near-term functional improvement for CSM. However, laminectomy is associated with late deterioration compared with the other types of anterior and posterior surgeries (Class III). Conclusions Multiple approaches exist with similar near-term improvements; however, laminectomy appears to have a late deterioration rate that may need to be considered when appropriate.

Four-Level Anterior Cervical Discectomy and Fusion With Plate Fixation

Neurosurgery ◽  
2010 ◽  
Vol 66 (4) ◽  
pp. 639-647 ◽  
Author(s):  
Steve W. Chang ◽  
Udaya K. Kakarla ◽  
Peter H. Maughan ◽  
Jeff DeSanto ◽  
Douglas Fox ◽  
...  
Keyword(s):  
Plate Fixation ◽  
Fusion Rate ◽  
Anterior Cervical Discectomy ◽  
Common Procedure ◽  
Radiographic Findings ◽  
Cervical Discectomy ◽  
Radiographic Outcomes ◽  
Multilevel Cervical Spondylotic Myelopathy ◽  
Age Range

Abstract OBJECTIVE Anterior cervical discectomy and fusion with plating is a common procedure performed for cervical spondylosis by spine surgeons. However, data on procedures involving 4 disc spaces are lacking. We report the outcomes of patients who underwent 4-level anterior cervical discectomy and fusion with plating at a single institution. METHODS Between 1997 and 2006, 34 patients (19 females, 15 males; mean age, 58 years; age range, 38–83 years) underwent 4-level anterior cervical discectomy and fusion with plating based on a surgical database search. Only patients undergoing surgery at 4 contiguous disc levels were included. Data were collected in a retrospective fashion. Patients' demographics, symptoms, neurologic findings, and radiographic findings at admission were recorded. Long-term clinical and radiographic outcomes at last follow-up were analyzed. RESULTS Twenty-nine patients (85%) underwent anterior cervical discectomy and fusion with plating at C3–C7. Sixteen patients presented with neurologic deficits, of which 14 (88%) improved. None worsened after surgery. Minor complications occurred in 26 patients, including transient dysphagia in 18 (53%) and hoarseness in 3 (9%). Radiographic outcomes were available in 27 patients (median follow-up, 15 months; range, 4–71 months). The overall fusion rate was 92.6%. Stable fibrous nonunions were present in 2 patients; the chance of nonunion was 1.9% per level and 7% per patient. Adjacent-level disease occurred in 2 patients. CONCLUSION In carefully selected patients, 4-level anterior cervical discectomy and fusion with plating can be associated with high rates of fusion. The technique is safe and effective for managing multilevel cervical spondylotic myelopathy and may obviate the need for circumferential procedures.

scholarly journals Comparison between selective caudal fixed screw construct and all variable screw construct in anterior cervical discectomy and fusion

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Jae Jun Yang ◽  
Sehan Park ◽  
Seongyun Park
Keyword(s):  
Fusion Rate ◽  
Anterior Cervical Discectomy ◽  
Disc Space ◽  
Cervical Discectomy ◽  
Locking Mechanism ◽  
Adjacent Disc ◽  
One Year ◽  
The Stability ◽  
Retrospective Comparative Study ◽  
Caudal Level

AbstractThis retrospective comparative study aimed to compare the efficacy of selective caudal fixed screw constructs with all variable screw constructs in anterior cervical discectomy and fusion (ACDF). Thirty-five patients who underwent surgery using selective caudal fixed screw construct (SF group) were compared with 44 patients who underwent surgery using all variable constructs (AV group). The fusion rate, subsidence, adjacent level ossification development (ALOD), adjacent segmental disease (ASD), and plate-adjacent disc space distance were assessed. The one-year fusion rates assessed by computed tomography bone bridging and interspinous motion as well as the significant subsidence rate did not differ significantly between the AV and SF groups. The ALOD and ASD rates and plate-adjacent disc space distances did not significantly differ between the two groups at both the cranial and caudal adjacent levels. The number of operated levels was significantly associated with pseudarthrosis in the logistic regression analysis. The stability provided by the locking mechanism of the fixed screw did not lead to an increased fusion rate at the caudal level. Therefore, the screw type should be selected based on individual patient’s anatomy and surgeon’s experience without concern for increased complications caused by screw type.

Sign in / Sign up

Export Citation Format

Share Document