BACKGROUND: Anterior cervical discectomy and fusion (ACDF) for cervical degenerative disease is an accepted treatment for symptomatic cervical radiculopathy and myelopathy. One- and two-level fusions are much more common and more widely studied. Outcomes and revision rates for three- and four-level ACDF have not been well described. The purpose of this study is to report on clinical outcomes and revision rates following multilevel ACDF. METHODS: Patients who underwent three- or four-level anterior cervical discectomy with plate fixation between 2006 and 2011 from a single-center multi-surgeon practice for symptomatic cervical degenerative disease were identified. Improvements in neck disability index (NDI), neck and arm pain scores two years after surgery and revision rates were analyzed. RESULTS: Forty-six patients with a mean age of 55.9 years were included in the analysis. Twenty-one (46%) were male, 10 (22%) were smokers. Forty-one (89%) underwent three-level fusion and 5 (11%) underwent four-level fusion. NDI improved from 34.46 at baseline to 25.47 at 2 years. Neck pain improved from 7.04 at baseline to 3.95 and arm pain improved from 6.24 to 3.09 at 2 year follow up. Sixteen patients (35%) returned to surgery within 2 years with 11 of these patients (24%) returning for non-union. The average number of days to revision surgery was 750.6±570.3 days. CONCLUSIONS: Patients undergoing three- and four-level ACDF for multilevel cervical disease demonstrate substantial improvement in outcomes. However, the two-year revision rate is relatively high at 35% with the majority of these patients returning due to non-union.
BACKGROUND: Anterior cervical discectomy and fusion (ACDF) for cervical degenerative disease is an accepted treatment for symptomatic cervical radiculopathy and myelopathy. One- and two-level fusions are much more common and more widely studied. Outcomes and revision rates for three- and four-level ACDF have not been well described. The purpose of this study is to report on clinical outcomes and revision rates following multilevel ACDF. METHODS: Patients who underwent three- or four-level anterior cervical discectomy with plate fixation between 2006 and 2011 from a single-center multi-surgeon practice for symptomatic cervical degenerative disease were identified. Improvements in neck disability index (NDI), neck and arm pain scores two years after surgery and revision rates were analyzed. RESULTS: Forty-six patients with a mean age of 55.9 years were included in the analysis. Twenty-one (46%) were male, 10 (22%) were smokers. Forty-one (89%) underwent three-level fusion and 5 (11%) underwent four-level fusion. NDI improved from 34.46 at baseline to 25.47 at 2 years. Neck pain improved from 7.04 at baseline to 3.95 and arm pain improved from 6.24 to 3.09 at 2 year follow up. Sixteen patients (35%) returned to surgery within 2 years with 11 of these patients (24%) returning for non-union. The average number of days to revision surgery was 750.6±570.3 days. CONCLUSIONS: Patients undergoing three- and four-level ACDF for multilevel cervical disease demonstrate substantial improvement in outcomes. However, the two-year revision rate is relatively high at 35% with the majority of these patients returning due to non-union.
Authors: Elias C Papadopoulos; Russel C Huang; Federico P Girardi; Keith Synnott; Frank P Cammisa Journal: Spine (Phila Pa 1976) Date: 2006-04-15 Impact factor: 3.468
Authors: Jay Jagannathan; Christopher I Shaffrey; Rod J Oskouian; Aaron S Dumont; Christian Herrold; Charles A Sansur; John A Jane Journal: J Neurosurg Spine Date: 2008-05
Authors: Helena Milavec; Christoph Kellner; Nivetha Ravikumar; Christoph E Albers; Till Lerch; Sven Hoppe; Moritz C Deml; Sebastian F Bigdon; Naresh Kumar; Lorin M Benneker Journal: J Funct Biomater Date: 2019-07-02
Authors: Peter Y Joo; Rahul H Jayaram; William M McLaughlin; Bijan Ameri; Alexander J Kammien; Paul M Arnold; Jonathan N Grauer Journal: N Am Spine Soc J Date: 2022-03-24
Authors: Anastasios Charalampidis; Nader Hejrati; Hari Ramakonar; Pratipal S Kalsi; Eric M Massicotte; Michael G Fehlings Journal: Sci Rep Date: 2022-03-29 Impact factor: 4.996