Improvement and Complications after Two-Level ACDF Surgery at a Tertiary Care Facility: A Retrospective Study
DOI:
https://doi.org/10.36552/pjns.v27i2.860Abstract
Objective: To assess immediate and long-term outcomes and complications of two-level ACDF in patients with degenerative cervical disc disease.
Materials & Methods: A retrospective study was carried out in the Department of Neurosurgery at Prime teaching hospital, Peshawar. Patients with symptoms of cervical radiculopathy and radiculomyelopathy with two-level cervical disc disease were included. Patients with trauma, single-level disease, and those who had cervical corpectomy were excluded. Age, gender, Nurick Grading, level of involvement, and post-op outcomes were recorded.
Results: 27 cases among which 18 were males and 9 females were studied. 21 patients had radiculopathy while 6 had radiculomyelopathy. The mean age was 46 years. Nurick grade was from 2 to 6. ACDF was chosen as the procedure of choice. Follow-up involved the immediate post-op period for dysphagia, hoarseness of voice, and any neurological deficit, at 6 months and one year for outcomes of pain relief, improvement in paresthesia, and spasticity.
Conclusion: ACDF is a safe and recommended procedure for 2-level cervical disc disease in terms of pain relief, paresthesia, and spasticity with acceptable complications.
References
References:
(1)ahmed, a. f., ateeq al dosari, m. a., kuwari, a. a., & khan, n. m. (2021). the outcomes of stand alone polyetheretherketone cages in anterior cervical discectomy and fusion. international orthopaedics, 45(1), 173-180. https://doi.org/10.1007/s00264-020-04760-1
(2)kadoya s, iizuka h, nakamura t. long-term outcome for surgically treated cervical spondylotic radiculopathy and myelopathy. neurol med chir (tokyo). 2003 may;43(5):228-40; discussion 241. doi: 10.2176/nmc.43.228. pmid: 12790282.
(3)zhang, y., yang, g., zhou, t., chen, y., gao, z., zhou, w., & gu, y. (2021). efficacy and safety of anterior cervical discectomy and fusion (acdf) through mini-incision and posterior laminoplasty (lamp) for treatment of long-level cervical spondylosis: a retrospective cohort study. bmc surgery, 22. https://doi.org/10.1186/s12893-022-01567-2
(4)mclaughlin mr, purighalla v, pizzi fj. cost advantages of two-level anterior cervical fusion with rigid internal fixation for radiculopathy and degenerative disease. surg neurol. 1997 dec;48(6):560-5. doi: 10.1016/s0090-3019(97)00366-2. pmid: 9400636.
(5)wu, x., ye, x., wang, z., & zou, d. (2017). anterior cervical discectomy and fusion versus anterior cervical corpectomy for cervical spondylotic myelopathy: a meta-analysis. world neurosurgery, 98, 719-727.
(6)kim, h. j., kim, y. j., kim, h. j., & kim, k. h. (2018). clinical outcomes of anterior cervical discectomy and fusion for cervical radiculopathy. journal of spinal disorders & techniques, 31(4), 199-204.
(7)wang, w., huang, y., wu, z., hu, x., xiang, p., liu, h., & yang, h. (2021). comparison of 3-level anterior cervical discectomy and fusion and open-door laminoplasty in cervical sagittal balance: a retrospective study. frontiers in surgery, 9. https://doi.org/10.3389/fsurg.2022.937479)
(8)kim, h. j., kim, y. j., kim, h. j., & kim, k. h. (2019). adjacent segment degeneration after anterior cervical discectomy and fusion: a systematic review and meta-analysis. journal of clinical neuroscience, 65, 169-174.
(9)kapetanakis, s., thomaidis, t., charitoudis, g., pavlidis, p., theodosiadis, p., & gkasdaris, g. (2017). single anterior cervical discectomy and fusion (acdf) using self- locking stand-alone polyetheretherketone (peek) cage: evaluation of pain and health-related quality of life. journal of spine surgery, 3(3), 312-322. https://doi.org/10.21037/jss.2017.06.21
(10)yee, t. j., swong, k., & park, p. (2020). complications of anterior cervical spine surgery: a systematic review of the literature. journal of spine surgery, 6(1), 302-322. https://doi.org/10.21037/jss.2020.01.14
(11)buttermann gr. anterior cervical discectomy and fusion outcomes over 10 years: a prospective study. spine (phila pa 1976). 2018 feb 1;43(3):207-214. doi: 10.1097/brs.0000000000002273. pmid: 28604488.
(12)kim, l. h., ho, a. l., pendharkar, a. v., sussman, e. s., rezaii, p., & desai, a. (2018). anterior techniques in managing cervical disc disease. cureus, 10(8). https://doi.org/10.7759/cureus.3146
(13)zuckerman, s. l., & devin, c. j. (2020). outcomes and value in elective cervical spine surgery: an introductory and practical narrative review. journal of spine surgery, 6(1), 89-105. https://doi.org/10.21037/jss.2020.01.11
(14)wang z, he m, jiang c, zhang f, du s, feng w, zhang h. matrix solid-phase dispersion coupled with homogeneous ionic liquid microextraction for the determination of sulfonamides in animal tissues using high-performance liquid chromatography. j sep sci. 2015 dec;38(23):4127-35. doi: 10.1002/jssc.201500777. epub 2015 nov 6. pmid: 26450655.
(15)fisher-owens sa, soobader mj, gansky sa, isong ia, weintraub ja, platt lj, newacheck pw. geography matters: state-level variation in children's oral health care access and oral health status. public health. 2016 may;134:54-63. doi: 10.1016/j.puhe.2015.04.024. epub 2016 mar 16. pmid: 26995567; pmcid: pmc4884054.
(16)young br, nguyen thp, alabaster a, greenhow tl. the prevalence of bacterial meningitis in febrile infants 29-60 days with positive urinalysis. hosp pediatr. 2018 aug;8(8):450-457. doi: 10.1542/hpeds.2017-0254. epub 2018 jul 9. pmid: 29987127.
(17)impellizzeri fm, bizzini m. systematic review and meta-analysis: a primer. int j sports phys ther. 2012 oct;7(5):493-503. pmid: 23091781; pmcid: pmc3474302.
(18)maharaj, m. m., mobbs, r. j., hogan, j., zhao, d. f., rao, p. j., & phan, k. (2015). anterior cervical disc arthroplasty (acda) versus anterior cervical discectomy and fusion (acdf): a systematic review and meta-analysis. journal of spine surgery, 1(1), 72-85. https://doi.org/10.3978/j.issn.2414-469x.2015.09.01
(19)goldstein, z. h., boody, b., & sasso, r. (2020). two-level anterior cervical discectomy and fusion versus cervical disc arthroplasty—long-term evidence update. international journal of spine surgery, 14(suppl 2), s36. https://doi.org/10.14444/7089
Downloads
Published
Issue
Section
License
Copyright (c) 2023 Sajid Khan, Akram Ullah, Bakht Jehan, Arif Hussain, Aaaq Ahmad Qarnain khalil, Mumtaz AliThe work published by PJNS is licensed under a Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0). Copyrights on any open access article published by Pakistan Journal of Neurological Surgery are retained by the author(s).
