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59th Annual Meeting of the German Society of Neurosurgery (DGNC)
3rd Joint Meeting with the Italian Neurosurgical Society (SINch)

German Society of Neurosurgery (DGNC)

1 - 4 June 2008, Würzburg

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Anterior cervical discectomy and titanium cage fusion – 7-year follow-up

Anteriore zervikale Diskektomie und Titancagefusion – Ergebnisse nach 7 Jahren

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  • corresponding author K. Schmieder - Neurochirurgische Klinik, Ruhr Universität Bochum, Deutschland
  • S. M. Rohe - Neurochirurgische Klinik, Ruhr Universität Bochum, Deutschland
  • I. Pechlivanis - Neurochirurgische Klinik, Ruhr Universität Bochum, Deutschland
  • M. Engelhardt - Neurochirurgische Klinik, Ruhr Universität Bochum, Deutschland
  • A. Harders - Neurochirurgische Klinik, Ruhr Universität Bochum, Deutschland

Deutsche Gesellschaft für Neurochirurgie. Società Italiana di Neurochirurgia. 59. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 3. Joint Meeting mit der Italienischen Gesellschaft für Neurochirurgie (SINch). Würzburg, 01.-04.06.2008. Düsseldorf: German Medical Science GMS Publishing House; 2008. DocMI.07.05

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgnc2008/08dgnc247.shtml

Published: May 30, 2008

© 2008 Schmieder et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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Objective: ACDF is the procedure of choice in patients with radiculopathy due to cervical disc herniation and/ or hard disc. Furthermore, patients with myelopathy due to mono- or bi-segmental stenosis of the spinal canal can be successfully treated with this method. The purpose of this study was to prospectively evaluate long-term results after ACDF and titanium cage fusion.

Methods: 54 patients (mean age 48±10 years) were entered into the study. All patients had ACDF between April and December 1999. 33 patients (mean age 56.4±9 years) could be re-evaluated after 7 years. Evaluation consisted of a clinical outpatient investigation by an independent investigator. VAS, PROLO and Oswestry were used and a lateral radiograph of the cervical spine was done and compared to the radiographs taken shortly after surgery. Changes in the adjacent segments were measured and compared to the radiographs obtained before and after surgery. Clinical patient data was compared with the results obtained by an independent investigator before and after surgery as well.

Results: Mean follow-up period was 7.26±0.22 years. One patient had a re-operation at the cervical spine within the investigational period. PROLO results both for functional and for economical scales showed a highly significant improvement (PROLO F 1.52±0.67 to 3.79±1.17 p<0.01; PROLO E 1.52±0.5 to 3.55±1.42 p<0.01). Mean VAS at the time of investigation was 2.7±2.8 (brachialgia), 3.8±2.7 (nuchalgia). Oswestry score was 16.4±9.5. On the lateral radiographs (n=31), no significant reduction of the disc space height in the adjacent levels was detectable. Total segmental height decreased from 36.6±4.6mm to 34.6±3.9mm (p=0.04). A significant progression of the degenerative changes could be detected, more pronounced in the superior disc space. The alignment of the whole cervical spine was stable throughout the investigational period (Katsuura 10.9±9.0° to 11.5±7.8°; p=0.76).

Conclusions: ACDF with titanium cages has good clinical results during long-term follow-up. Progressive radiological changes are detectable but without influence on the clinical outcome.