Mid to Long-term Outcome of Anterior Cervical Discectomy with Fusion
Keywords:Cervical spondylosis, myelopathy, anterior cervical discectomy
Background: Cervical degenerative conditions such as intervertebral disc prolapse and degenerative cervical spondylosis results in pain and disability, especially in the middle age and elderly. The treatment of choice is surgical decompression once conservative treatment fails. We studied the outcome of anterior cervical decom-pression with instrumented fusion in order to analyse its effectiveness in terms of pain and disability improve-ment. Materials and Methods: This is a retrospective descriptive study. 30 patients were operated during June 2013 and May 2015 (2 years). All patients operated for cervical degenerative conditions were included.Data was collected about neck pain and functional impairment preoperatively using visual analogue scale (VAS) and Japanese Orthopaedic Association (JOA) scores. The same scales were used during the follow-period for 6 months. Favourable outcome was defined as 50% reduction in pain and functional improvement to Grade 1 (12 – 15) or normal scores (16 – 17). Results: Mean age was 59.70 years ±8.12SD.Mean preoperative VAS was 6.70 and it was 1.80 ± 0.85 SD at 6 – month follow-up. Mean JOA score was 11.57 preoperatively while at 6-month follow-up, it was 14.97 ± 1.92 SD. There was a significant difference between mean VAS score preoperatively and mean VAS score postoperatively (mean difference; 4.9, 95% CI; 4.48 to 5.32, p < 0.001, t(29): 23.86). Similarly, there was statistically significant difference between mean JOA score preoperatively and mean JOA scores postoperatively (mean difference; -3.4, 95% CI; -3.95 to -2.85, p < 0.001, t(29): -12.61). Conclusion: Anterior cervical decompression with graft placement and instrumented fusion are safe and effective methods for relieving pain as well functional improvement in patients with cervical radiculopathy and myelopathy.
Keywords: , , , , surgical outcome.
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