User Tools

Site Tools


anterior_cervical_discectomy_outcome

Anterior cervical discectomy outcome

see also Anterior cervical discectomy and fusion outcome.

Only a few studies have compared ACD alone with fusion techniques and they all do not show any superiority of a fusion method compared to ACD without fusion 1) 2) 3) 4) 5) 6).

Avoidance of the use of implants reduces costs of surgery. More importantly, these studies revealed that ACD alone resulted in a shorter surgery procedure, hospital stay and sick leave 7) 8) 9).

Sleep quality

The aim of a study was find out the comparison in the quality of sleep between before (pre) and after (post) surgery cervical HNP patients.

This study was a retrospective cohort study. Ninety patients were asked to complete the Pittsburgh Sleep Quality Index questionnaire. All data which has been computed were analysed with the McNemar test.

The outcome reveals that from 90 patient`s cervical HNP, 81 (90%) were 40 years old age group and 66 (73.3%) of them were women. The result showed that 66 (73.3%) patients have a bad sleep quality before surgery. Surgery has increased the quality of sleep after surgery 66 (73.3%) patients had good sleep quality. There was a significant difference in the quality of sleep pre and post operation (p = 0.001).

There was a significant difference in the quality of sleep between pre and post operation cervical HNP patient utilising anterior discectomy methods 10).

Case series

1988

Between 1976 and 1983, 251 patients underwent surgery for the treatment of cervical degenerative disc disease. Anterior microsurgical discectomy at one or more cervical segments without interbody fusion was performed in each case. 109 patients with radiculopathy and 55 patients with myelopathy were followed up clinically 1 to 8 years postoperatively. A soft disc lesion was found in 72, a hard disc lesion in 92 patients. Of all radicular symptoms and signs, brachialgia and motor deficits of the upper extremities showed the highest improvement rates. The medullary complaints were improved in 80%, the progression of the disease was arrested in 93% of myelopathic cases. An excellent or good long-term result was achieved in 82% of patients with radiculopathy and 55% of those with myelopathy. The outcome was best in cases with soft disc lesions, with monosegmental disease, in individuals under 50 years of age, and in patients with a sudden onset and a short duration of symptoms. These results are comparable with those obtained by other surgical methods.

1) , 7)
Abd-Alrahman N, Dokmak AS, Abou-Madawi A. Anterior cervical discectomy (ACD) versus anterior cervical fusion (ACF), clinical and radiological outcome study. Acta Neurochir (Wien). 1999;141(10):1089-92. PubMed PMID: 10550654.
2)
la Torre M, Martinez-Quinones JV, Isla A, Arguello C, Bendala A, Casado J, Blazquez MG. Anterior cervical discectomy with and without bone grafting. Multicentric comparative study. J Bone Joint Surg Br. 1995;77B(Suppl 1):24.
3) , 8)
Dowd GC, Wirth FP. Anterior cervical discectomy: is fusion necessary? J Neurosurg. 1999 Jan;90(1 Suppl):8-12. PubMed PMID: 10413119.
4)
Jacobs WC, Anderson PG, Limbeek J, Willems PC, Pavlov P. Single or double-level anterior interbody fusion techniques for cervical degenerative disc disease. Cochrane Database Syst Rev. 2004 Oct 18;(4):CD004958. Review. Update in: Cochrane Database Syst Rev. 2011;(1):CD004958. PubMed PMID: 15495130.
5)
Martins AN. Anterior cervical discectomy with and without interbody bone graft. J Neurosurg. 1976 Mar;44(3):290-5. PubMed PMID: 765435.
6)
McConnell JR, Freeman BJ, Debnath UK, Grevitt MP, Prince HG, Webb JK. A prospective randomized comparison of coralline hydroxyapatite with autograft in cervical interbody fusion. Spine (Phila Pa 1976). 2003 Feb 15;28(4):317-23. PubMed PMID: 12590203.
9)
Rosenørn J, Hansen EB, Rosenørn MA. Anterior cervical discectomy with and without fusion. A prospective study. J Neurosurg. 1983 Aug;59(2):252-5. PubMed PMID: 6864291.
10)
Dharmajaya R, Sari DK, Ganie RA. A Comparison of the Quality of Sleep between Pre and Post-Surgery Cervical Herniated Nucleus Pulposus Patients Utilizing the Anterior Discectomy Method. Open Access Maced J Med Sci. 2017 Dec 10;5(7):948-954. doi: 10.3889/oamjms.2017.209. eCollection 2017 Dec 15. PubMed PMID: 29362625; PubMed Central PMCID: PMC5771301.
anterior_cervical_discectomy_outcome.txt · Last modified: 2018/01/25 12:16 by administrador