surgical treatment of cervical degenerative disc disease with myeloradiculopathy: two-level anterior...
TRANSCRIPT
SURGICAL TREATMENT OF CERVICAL DEGENERATIVE DISC DISEASE WITH
MYELORADICULOPATHY: TWO-LEVEL ANTERIOR DISCECTOMY VERSUS ONE LEVEL ANTERIOR
CORPECTOMY
Istanbul Spine Center
Florence Nightingale Hospital
Istanbul-TURKEY
Ahmet ALANAY, MD
Kursat GANIYUSUFOGLU, MD
Selhan KARADERELER, MD
Mehmet AYDOGAN, MD
Cagatay OZTURK, MD
Azmi HAMZAOGLU, MD
PURPOSE The aim of this retrospective study is to compare two
fusion techniques with reference to perioperative and
radiological parameters and clinical outcomes.
MATERIALS & METHODS74 patients having surgery due to 2-level cervical
spondylotic myeloradiculopathy
Surgery;
ACDF (two contiguous levels)
ACCF (single level including 2 disc spaces)
MATERIALS & METHODS
The perioperative parameters
Hospitalization
Blood loss
Operation times
Complications
The radiologic parameters
Cervical lordosis
Fusion rate
The clinical parameters
Visual Analog Scale
[VAS] scores of neck
and arm pain
RESULTSACDF ACCF
# of patients 47 27
Mean age (y) 53.7 55.3
Male to Female ratio 21/26 11/16
Mean F/U (m) 48.4 51.2
Perioperative parameters ACDF ACCF p
Hospitalization (day) 5.2 5.4 >0.05
Blood loss (cc) 283 342 >0.05
Operation time (minutes) 180 210 >0.05
Complications* 4/47 2/27 >0.05
*ACDF: dura laceration in 1, hoarseness in 3 patients.
*ACCF: dura laceration in 1, incomplete transient C5 palsy in 1 patient.
RESULTSClinical Outcomes ACDF ACCF p
Preop neck VAS 5.6 5.4 >0.05
Postop neck VAS 2.8 2.5 >0.05
Preop arm VAS 6.2 5.9 >0.05
Postop arm VAS 2.7 2.6 >0.05
Radiological parameters
ACDF ACCF p
Fusion rate (%) 100 100 >0.05
Preop cervical lordosis (degrees)
18.3 17.4 >0.05
Postop cervical lordosis (degrees)
24.4 21.6 0.045
MT, 47 y, M
MT, 49 y, M
CONCLUSION
Surgical management of 2-level cervical degenerative
disc disease with myeloradiculopathy by ACDF or ACCF
showed no significant differences in terms of clinical
symptom improvement and fusion rates.
CONCLUSION
Although statistically insignificant, blood loss and
operation times were lower in ACDF group.
In addition, ACCF provided less improvement in cervical
lordosis.
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