Clinical Features and Short-Term Outcome Analysis of Anterior Cervical Discectomy; Effect of Instrumented Vs Non-Instrumented Fusion

Abstract

Objective: To study the effects of instrumented vs non-instrumented anterior cervical decompression & fusion procedures for various degenerative cervical disorders in terms of improvements in pain & disability.

Methods: Twenty three patients who were operated for cervical degenerative disorders from January 2014 to December 2014 were included. Patients with more than one segmental level involvement were excluded. Clinical features and preoperative pain & disability were recorded using the visual analogue scale (VAS), the Japanese Orthopaedic Association (JOA) score, Nurik grading. Postoperative outcome was recorded using improvement or deterioration in VAS, JOA score and Odom criteria.

Results: Twenty three patients were included with average mean of age 58.57 years ±8.71 SD. Anterior Cervical Decompression & Fusion (ACDF) was performed in 13 (56.5%) and anterior cervical discectomy (ACD) only in 10 (43.5%) patients. Median preoperative VAS was 7.00 while at 3-month follow-up it was 2.00 with SD ± 0.85 SD. The preoperative median JOA score was 11.00 while at 3-month follow-up it was 16.00 (mean: 15.13) ± 1.79 SD. The decrease in median VAS (Z = - 4.246) & JOA scores (Z = - 4.218) for both groups of intervention was statistically significant at 3- month follow-up (p < 0.001).

Conclusion: Anterior cervical procedures are associated with excellent short-term outcome in terms of pain and disability improvement. ACDF takes longer operative time but postoperative length of stay is comparable in both groups.

Keywords: Cervical spondylosis, anterior cervical discectomy, fusion, surgical outcome