OBJECTIVE: Anterior cervical discectomy and fusion with plating is a common procedure performed for cervical spondylosis by spine surgeons. However, data on procedures involving 4 disc spaces are lacking. We report the outcomes of patients who underwent 4-level anterior cervical discectomy and fusion with plating at a single institution. METHODS: Between 1997 and 2006, 34 patients (19 females, 15 males; mean age, 58 years; age range, 38-83 years) underwent 4-level anterior cervical discectomy and fusion with plating based on a surgical database search. Only patients undergoing surgery at 4 contiguous disc levels were included. Data were collected in a retrospective fashion. Patients' demographics, symptoms, neurologic findings, and radiographic findings at admission were recorded. Long-term clinical and radiographic outcomes at last follow-up were analyzed. RESULTS: Twenty-nine patients (85%) underwent anterior cervical discectomy and fusion with plating at C3-C7. Sixteen patients presented with neurologic deficits, of which 14 (88%) improved. None worsened after surgery. Minor complications occurred in 26 patients, including transient dysphagia in 18 (53%) and hoarseness in 3 (9%). Radiographic outcomes were available in 27 patients (median follow-up, 15 months; range, 4-71 months). The overall fusion rate was 92.6%. Stable fibrous nonunions were present in 2 patients; the chance of nonunion was 1.9% per level and 7% per patient. Adjacent-level disease occurred in 2 patients. CONCLUSION: In carefully selected patients, 4-level anterior cervical discectomy and fusion with plating can be associated with high rates of fusion. The technique is safe and effective for managing multilevel cervical spondylotic myelopathy and may obviate the need for circumferential procedures.
OBJECTIVE: Anterior cervical discectomy and fusion with plating is a common procedure performed for cervical spondylosis by spine surgeons. However, data on procedures involving 4 disc spaces are lacking. We report the outcomes of patients who underwent 4-level anterior cervical discectomy and fusion with plating at a single institution. METHODS: Between 1997 and 2006, 34 patients (19 females, 15 males; mean age, 58 years; age range, 38-83 years) underwent 4-level anterior cervical discectomy and fusion with plating based on a surgical database search. Only patients undergoing surgery at 4 contiguous disc levels were included. Data were collected in a retrospective fashion. Patients' demographics, symptoms, neurologic findings, and radiographic findings at admission were recorded. Long-term clinical and radiographic outcomes at last follow-up were analyzed. RESULTS: Twenty-nine patients (85%) underwent anterior cervical discectomy and fusion with plating at C3-C7. Sixteen patients presented with neurologic deficits, of which 14 (88%) improved. None worsened after surgery. Minor complications occurred in 26 patients, including transient dysphagia in 18 (53%) and hoarseness in 3 (9%). Radiographic outcomes were available in 27 patients (median follow-up, 15 months; range, 4-71 months). The overall fusion rate was 92.6%. Stable fibrous nonunions were present in 2 patients; the chance of nonunion was 1.9% per level and 7% per patient. Adjacent-level disease occurred in 2 patients. CONCLUSION: In carefully selected patients, 4-level anterior cervical discectomy and fusion with plating can be associated with high rates of fusion. The technique is safe and effective for managing multilevel cervical spondylotic myelopathy and may obviate the need for circumferential procedures.
Authors: Bryce A Basques; Philip K Louie; Jeremy Mormol; Jannat M Khan; Kamran Movassaghi; Justin C Paul; Arya Varthi; Edward J Goldberg; Howard S An Journal: Eur Spine J Date: 2018-06-26 Impact factor: 3.134
Authors: Stavros G Memtsoudis; Alexander Hughes; Yan Ma; Ya Lin Chiu; Andrew A Sama; Federico P Girardi Journal: Clin Orthop Relat Res Date: 2011-03 Impact factor: 4.176
Authors: Lawrence J Oh; Sam Ong; Sherief Ghozy; Adam A Dmytriw; Jeffrey Zuccato; Ralph Mobbs; Kevin Phan; Mahmoud Dibas; Harrison Faulkner Journal: J Spine Surg Date: 2020-09