Article
Anterior cervical discectomy and fusion with an autologous iliac crest and anterior plate stabilization – A retrospective follow up study with a mean of 22 years
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Authors
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Benedikt W. Burkhardt
- Universitätsklinikum des Saarlandes, Klinik für Neurochirurgie, Homburg-Saar, Deutschland
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Moritz Brielmaier
- Universitätsklinikum des Saarlandes, Klinik für Neurochirurgie, Homburg-Saar, Deutschland
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Guilherme Ramina Montibeller
- Universitätsklinikum des Saarlandes, Klinik für Neurochirurgie, Homburg-Saar, Deutschland
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Joachim M. K. Oertel
- Universitätsklinikum des Saarlandes, Klinik für Neurochirurgie, Homburg-Saar, Deutschland
| Published: | April 24, 2015 |
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Outline
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Introduction: To evaluate the long-term clinical results of ACDF and plate stabilization with special focus on neurological and pain outcome after this procedure.
Material and methods: Hospital records were used to obtain information about diagnosis, surgery and complications. Patients were reviewed with a standardized questionnaire including the current neurological status, NDI, EQ-5D, PSI, HADS-Score, Odom`s criteria, complications at the iliac crest donor side and limitations in quality of life.
Results: Sixty-five patients were included in this follow-up study. Mean follow-up time was 22 years. ACDF and plate stabilization was performed at one level in 28 patients, at two levels in 29 patients, and at three levels in 8 patients. Fifty-nine (98.3%) of the patients with preoperative pain had complete or nearly complete relief of pain. Fifty (83.3%) patients remained free of pain and had no second surgery due to degenerative cervical disease. The mean neck disability index (NDI) was 7, and mean score for EQ-5D was 5. 100% of patients were satisfied with their outcome (PSI). 86.2% of patients reported good to excellent functional recovery according to Odom`s criteria. Six patients had second surgery for plate removal due to dysphagia. Two patients underwent second surgery due to degenerative changes at the cervical spine. All 65 patients would decide to undergo ACDF with plate stabilization as therapy again.
Conclusion: ACDF and plate stabilization yields significant decrease in pain, a significant increase in function and a high degree of patient satisfaction. Overall prevalence for adjacent segment disease (ASD) is 3.1% after 20 years.
