scholarly journals Anterior cervical discectomy in a patient with huge thyroid tissue (goiter)

2014 ◽  
Vol 05 (S 01) ◽  
pp. S083-S085
Author(s):  
Salih Gulsen
Keyword(s):  
Thyroid Gland ◽  
Muscle Strength ◽  
Anterior Part ◽  
Thyroid Tissue ◽  
Anterior Cervical Discectomy ◽  
Cervical Discectomy ◽  
Arm Pain ◽  
Triceps Muscle ◽  
Cervical Approach ◽  
Anterior Cervical Approach

ABSTRACTEnlarged thyroid gland (goiter) may hinder to reach anterior part of the vertebrae or may impose more retraction than usual. The patient had left arm pain, and his left biceps muscle strength was 3/5 and triceps muscle strength was 4/5. Physical examination of his neck showed no abnormality. We performed anterior cervical discectomy, but we did not reach to the anterior part of the vertebrae due to enlarged thyroid gland even making moderately forceful medial retraction. It is therefore, we performed thyroidectomy previously, and later we performed anterior cervical discectomy at the level of cervical 5-6 and cervical 6-7. It will be wise to excise the goiter and later continue to cervical discectomy rather than using forceful retraction in cases with no preoperative detection as in our case to prevent damage of the recurrent laryngeal nerve and hoarseness due to pressure effect of the medial retraction during the anterior cervical approach.

Anterior cervical arthrodesis using DOC dynamic stabilization implant for improvement in sagittal angulation and controlled settling

2003 ◽  
Vol 98 (1) ◽  
pp. 8-13 ◽  
Author(s):  
Bikash Bose
Keyword(s):  
Anterior Cervical Discectomy ◽  
Related Complication ◽  
Common Procedure ◽  
Content Type ◽  
Cervical Discectomy ◽  
Arm Pain ◽  
Advantages And Disadvantages ◽  
Cervical Spondylotic Radiculopathy ◽  
Donor Graft ◽  
Fine Print

Object. Placing instrumentation in the anterior cervical spine is a common procedure. The bi- and unicortical systems currently available, however, have distinct advantages and disadvantages. The author reports a prospective series in which a new dynamized anterior cervical fixation system was evaluated. Methods. Thirty-seven patients underwent anterior cervical discectomy and fusion in which the DOC ventral cervical stabilization system was used for indications including cervical spondylotic radiculopathy, disc herniation, trauma, and myelopathy. Patients underwent anterior cervical discectomy and interbody fusion and/or corpectomy. Preoperative and postoperative clinical data included assessment of spinal cord and nerve root deficit, function, neck pain, and arm pain. Preoperative and postoperative radiographic data included sagittal angle, translation, and settling of the graft. Fusion status was determined by the presence of trabecular bridging bone on plain anteroposterior and lateral cervical radiographs. At a mean follow-up time of 1.3 years, postoperative neck or arm pain was resolved in 52% of the patients, restriction on function was mild or absent in 88%, and fusion was successful in 80% of patients and 88% of the treated levels. There was one implant-related complication, one significant dysphagia complication, and a 10.8% donor graft site complication rate. Conclusions. The use of this system led to a high percentage of pain relief and radiographic fusion. The sagittal angle was controlled while allowing for graft settling. There were no implant failures.

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 Two-Year Clinical and Radiological Outcomes in Patients With Diabetes Undergoing Single-Level Anterior Cervical Discectomy and Fusion

2020 ◽  
pp. 219256822091488
Author(s):  
Paul M. Arnold ◽  
Alexander R. Vaccaro ◽  
Rick C. Sasso ◽  
Benoit Goulet ◽  
Michael G. Fehlings ◽  
...  
Keyword(s):  
Short Form ◽  
Secondary Analysis ◽  
Neck Disability Index ◽  
Cervical Radiculopathy ◽  
Anterior Cervical Discectomy ◽  
Disc Disease ◽  
Cervical Discectomy ◽  
Single Level ◽  
Arm Pain ◽  
Patients With Diabetes

Study Design: Secondary analysis of data from the multicenter, randomized, parallel-controlled Food and Drug Administration (FDA) investigational device exemption study. Objective: Studies on outcomes following anterior cervical discectomy and fusion (ACDF) in individuals with diabetes are scarce. We compared 24-month radiological and clinical outcomes in individuals with and without diabetes undergoing single-level ACDF with either i-FACTOR or local autologous bone. Methods: Between 2006 and 2013, 319 individuals with single-level degenerative disc disease (DDD) and no previous fusion at the index level underwent ACDF. The presence of diabetes determined the 2 cohorts. Data collected included radiological fusion evaluation, neurological outcomes, Neck Disability Index (NDI), Visual Analog Scale (VAS) scores, and the 36-Item Short Form Survey Version 2 (SF-36v2) Physical and Mental component summary scores. Results: There were 35 individuals with diabetes (11.1%; average body mass index [BMI] = 32.99 kg/m2; SD = 5.72) and 284 without (average BMI = 28.32 kg/m2; SD = 5.67). The number of nondiabetic smokers was significantly higher than diabetic smokers: 73 (25.70%) and 3 (8.57%), respectively. Preoperative scores of NDI, VAS arm pain, and SF-36v2 were similar between the diabetic and nondiabetic participants at baseline; however, VAS neck pain differed significantly between the cohorts at baseline ( P = .0089). Maximum improvement for NDI, VAS neck and arm pain, and SF-36v2 PCS and MCS scores was seen at 6 months in both cohorts and remained stable until 24 months. Conclusions: ACDF is effective for cervical radiculopathy in patients with diabetes. Diabetes is not a contraindication for patients requiring single-level surgery for cervical DDD.

Comparative analysis of anterior cervical discectomy and fusion in the inpatient versus outpatient surgical setting

2019 ◽  
Vol 31 (2) ◽  
pp. 255-260 ◽  
Author(s):  
Dil V. Patel ◽  
Joon S. Yoo ◽  
Brittany E. Haws ◽  
Benjamin Khechen ◽  
Eric H. Lamoutte ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Hospital Setting ◽  
Outpatient Setting ◽  
Anterior Cervical Discectomy ◽  
Cervical Discectomy ◽  
Arm Pain ◽  
Pain Scores ◽  
Comorbidity Burden ◽  
Chi Square Analysis ◽  
Surgical Setting

OBJECTIVEIn a large, consecutive series of patients treated with anterior cervical discectomy and fusion (ACDF) performed by a single surgeon, the authors compared the clinical and surgical outcomes of patients who underwent ACDF in an inpatient versus outpatient setting.METHODSPatients undergoing primary ACDF were retrospectively reviewed and stratified by surgical setting: hospital or ambulatory surgical center (ASC). Data regarding perioperative characteristics, including hospital length of stay and complications, were collected. Neck Disability Index (NDI) and visual analog scale (VAS) scores were used to analyze neck and arm pain in the preoperative period and at 6 weeks, 3 months, 6 months, and 12 months postoperatively. Postoperative outcomes were compared using chi-square analysis and linear regression.RESULTSThe study included 272 consecutive patients undergoing a primary ACDF, of whom 172 patients underwent surgery at a hospital and 100 patients underwent surgery at an ASC. Patients undergoing ACDF in the hospital setting were older, more likely to be diabetic, and had a higher comorbidity burden. Patients receiving treatment in the ASC were more likely to carry Workers’ Compensation insurance. Patients in the hospital cohort were more likely to have multilevel procedures, had greater blood loss, and experienced a longer length of stay. In the hospital cohort, 48.3% of patients were discharged within 24 hours, while 43.0% were discharged between 24 and 48 hours after admission. Both cohorts had similar VAS pain scores on postoperative day (POD) 0; however, the hospital cohort consumed more narcotics on POD 0. One patient in the ASC cohort had a pretracheal hematoma that was evacuated immediately in the same surgical center. There were 8 cases of dysphagia in the hospital cohort and 3 cases in the ASC cohort, all of which resolved before the 6-month follow-up. Both cohorts demonstrated similar NDI and VAS neck and arm pain scores preoperatively and at every postoperative time point.CONCLUSIONSAlthough patients undergoing ACDF in the hospital setting were older, had a greater comorbidity burden, and underwent surgery on more levels than patients undergoing ACDF at an outpatient center, this study demonstrated comparable surgical and clinical outcomes for both patient groups. Based on the results of this single surgeon’s experience, 1- to 2-level ACDFs may be performed successfully in the outpatient setting in appropriately selected patient populations.

scholarly journals A rare case report of laryngopharyngeal polyp formation following anterior cervical discectomy and fusion (ACDF)

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Xiucheng Li ◽  
Lei He ◽  
Wei He ◽  
Zuo Lv ◽  
Xuerong Chen
Keyword(s):  
Muscle Strength ◽  
Internal Fixation ◽  
Anterior Cervical Discectomy ◽  
Cervical Discectomy ◽  
Polyp Formation ◽  
Rare Case Report ◽  
Pharyngeal Perforation ◽  
One Year ◽  
Adjacent Segments

Abstract Background Anterior Cervical Discectomy and Fusion (ACDF) has been regarded as the “gold standard” treatment of cervical spondylosis. Though it has good outcomes, many complications still exist, such as loss of fixation, degeneration of adjacent segments, dysphagia and pharyngeal perforation. In view of current literature, this study is the first to report a case of laryngopharyngeal polyp following ACDF. Case presentation A 63 year old male patient suffered from cervical spine hyperextension after trauma accompanied by numbness of the hands and decreased muscle strength in both upper limbs. Anterior cervical fusion surgery was performed in our hospital, after which the patient’s upper limb numbness disappeared and muscle strength returned to normal. In the fifth month after surgery, the patient developed a sore throat and dysphagia. Symptoms gradually worsened, and the patient was hospitalized four times, subsequently undergoing tracheotomy, internal fixation removal, and polypectomy. The patient’s pronunciation, breathing, and swallowing functions returned to normal, and the incision healed. After a one-year follow-up, the polyp did not recur. Conclusions Laryngopharyngeal polyp formation following ACDF has yet to be reported in literature. By excluding esophageal fistula as soon as possible, removing internal fixation and polypectomy serves as the best treatment in relieving patient symptoms.

Use of the Solis cage and local autologous bone graft for anterior cervical discectomy and fusion: early technical experience

2005 ◽  
Vol 2 (2) ◽  
pp. 116-122 ◽  
Author(s):  
Amjad Shad ◽  
John C. D. Leach ◽  
Peter J. Teddy ◽  
Tom A. D. Cadoux-Hudson
Keyword(s):  
Neck Pain ◽  
Donor Site ◽  
Japanese Orthopaedic Association ◽  
Autologous Bone Graft ◽  
Anterior Cervical Discectomy ◽  
Anterior Plate ◽  
Content Type ◽  
Cervical Discectomy ◽  
Arm Pain ◽  
Fine Print

Object. The authors prospectively evaluated the clinical and radiological outcomes after anterior cervical discectomy and fusion (ACDF) involving placement of a Solis cage and local autograft in patients who presented with symptomatic cervical spondylosis. Methods. Twenty-two consecutive patients underwent ACDF for radiculopathy (13 cases), myeloradiculopathy (eight cases), or myelopathy alone (one case) and were assessed at 3, 6, and 12 months. Plain cervical spine radiography demonstrated a significant change in both local (p < 0.05) and regional (p < 0.05) kyphotic angles as well as an increase in segmental height (p < 0.05). At 12 months, plain radiography demonstrated Grades I, II, and III new bone formation in two, three, and 17 patients, respectively. Clinical outcomes were assessed using a visual analog scale for both neck and arm pain and a modified Japanese Orthopaedic Association (JOA) scale for myelopathy. There was a significant improvement in both arm (p < 0.05) and neck pain (p < 0.05). At 12 months, 16 (84%) of 19 and 19 (86%) of 22 patients reported complete resolution of arm pain and neck pain, respectively. There was a significant improvement in JOA scores following surgery (p < 0.05). There were two complications in the series: one case of deep venous thrombosis and one case of postoperative arm pain that resolved after conservative treatment. There were no technical complications. Conclusions. Early experience with Solis cage—augmented ACDF indicates good clinical and radiological outcomes; additionally, there are the advantages of absent donor site morbidity and anterior plate system—related morbidity.

Improvements in Neck and Arm Pain Following an Anterior Cervical Discectomy and Fusion

Spine ◽  
2017 ◽  
Vol 42 (14) ◽  
pp. E825-E832 ◽  
Author(s):  
Dustin H. Massel ◽  
Benjamin C. Mayo ◽  
Daniel D. Bohl ◽  
Ankur S. Narain ◽  
Fady Y. Hijji ◽  
...  
Keyword(s):  
Anterior Cervical Discectomy ◽  
Cervical Discectomy ◽  
Arm Pain

Pseudarthrosis in anterior cervical discectomy and fusion with a self-locking, stand-alone cage filled with hydroxyapatite: a retrospective study with clinical and radiological outcomes of 98 levels with a minimum 2-year follow-up

2020 ◽  
Vol 33 (6) ◽  
pp. 717-726
Author(s):  
Eduardo A. Iunes ◽  
Enrico A. Barletta ◽  
Telmo A. B. Belsuzarri ◽  
Franz J. Onishi ◽  
André Y. Aihara ◽  
...  
Keyword(s):  
Statistical Significance ◽  
Neck Disability Index ◽  
Wilcoxon Test ◽  
Anterior Cervical Discectomy ◽  
Adjacent Level ◽  
Disc Disease ◽  
Cervical Discectomy ◽  
Arm Pain ◽  
Pain Status

OBJECTIVEThe goal of this study was to evaluate the incidence of pseudarthrosis after the treatment of cervical degenerative disc disease (CDDD) with anterior cervical discectomy and fusion (ACDF) in which self-locking, stand-alone intervertebral cages filled with hydroxyapatite were used.METHODSThe authors performed a retrospective cohort study of 49 patients who underwent 1- to 3-level ACDF with self-locking, stand-alone intervertebral cages without plates, with a minimum 2 years of follow-up. The following data were extracted from radiological and clinical charts: age, sex, time and type of pre- and postoperative signs and symptoms, pain status (visual analog scale [VAS]), functional status (Neck Disability Index [NDI]), history of smoking, bone quality (bone densitometry), and complications. Pseudarthrosis was diagnosed by a blinded neuroradiologist using CT scans. Clinical improvement was assessed using pre- and postoperative comparison of VAS and NDI scores. The Wilcoxon test for paired tests was used to evaluate statistical significance using a p value of < 0.05.RESULTSThree patients (6%) developed symptomatic pseudarthrosis requiring reoperation, with only 1 patient showing clinical worsening due to pseudarthrosis, while the other 2 with pseudarthrosis had associated disc disease at an adjacent level. The rate of symptomatic pseudarthrosis according to the number of operated levels was 0% for 1 level, 8.7% (2/23 patients) for 2 levels, and 7.7% (1/13 patients) for 3 levels. The total pseudarthrosis rate (including both symptomatic and asymptomatic patients) was 16.4%. Considering the clinical outcomes, there was a significant improvement of 75.6% in neck pain and 95.7% in arm pain, as well as a 64.9% improvement in NDI scores. Complications were observed in 18.4% of patients, with adjacent-level degenerative disease being the most prevalent at 14.3%.CONCLUSIONSACDF with self-locking, stand-alone cages filled with a hydroxyapatite graft can be used for the surgical treatment of 1- to 3-level CDDD with clinical and radiological outcomes significantly improved after a minimum 2-year follow-up period. Comparative studies are necessary.

scholarly journals Current practice of cervical disc arthroplasty: a survey among 383 AOSpine International members

2017 ◽  
Vol 42 (2) ◽  
pp. E8 ◽  
Author(s):  
Timothy C. Chin-See-Chong ◽  
Pravesh S. Gadjradj ◽  
Robert J. Boelen ◽  
Biswadjiet S. Harhangi
Keyword(s):  
Geographic Location ◽  
Standard Technique ◽  
Anterior Cervical Discectomy ◽  
Cervical Disc ◽  
Cervical Disc Arthroplasty ◽  
Large Sample Size ◽  
Adjacent Level ◽  
Disc Arthroplasty ◽  
Cervical Discectomy ◽  
Arm Pain

OBJECTIVE The use of cervical disc arthroplasty (CDA) in spinal practice is controversial. This may be explained by the lack of studies with a large sample size and long-term outcomes. With this survey the authors aimed to evaluate the opinions of spine surgeons on the use of CDA in the current treatment of cervical disc herniation (CDH). METHODS A web-based survey was sent to all members of AOSpine International by email using SurveyMonkey on July 18, 2016. A single reminder was sent on August 18, 2016. Questions included geographic location; specialty; associated practice model; number of discectomies performed annually; the use of CDA, anterior cervical discectomy (ACD), and anterior cervical discectomy and fusion (ACDF); and the expectations for clinical outcomes of these procedures. RESULTS A total of 383 questionnaires were analyzed. Almost all practitioners (97.9%) were male, with a mean of 15.0 ± 9.7 years of clinical experience. The majority of responders were orthopedic surgeons (54.6%). 84.3% performed ACDF as the standard technique for CDH. 47.8% of the surgeons occasionally used CDA, whereas 7.3% used CDA as standard approach for CDH. The most common arthroplasty device used was the ProDisc-C. Low evidence for benefits and higher costs were the most important reasons for not offering CDA. The risk of adjacent-level disease was considered smaller for CDA as compared with ACDF. However, ACDF was expected to have the highest effectiveness on arm pain (87.5%), followed by CDA (77.9%), while ACD had the least (12.6%). CONCLUSIONS In this survey, CDA was not considered to be the routine procedure to treat CDH. Reported benefits included the reduced risk of adjacent-level disease and preservation of motion of the neck. Lack of enough evidence on its effectiveness as well as higher costs were considered to be disadvantages of CDA. More research should be conducted on the implementation impact of CDA and the cost-effectiveness from society's perspective.

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>

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