Egyptian Spine Journal (Jan 2013)
Outcome Evaluation of Anterior Cervical Discectomy with fusion Versus Corpectomy in Spondylotic Myelopathic Patients
Abstract
Background Data: Anterior cervical discectomy and fusion and anterior cervical corpectomy and fusion both are used as a surgical technique in the cervical spondylotic myelopathic cases but yet no comparison was done of which is superior, and has a better outcome even after long term follow up. Purpose: To evaluate the outcome of surgical interference for cervical myelopathy either using anterior cervical discectomy versus corpectomy. Study Design: This is a prospective comparative clinical case study Patients and Methods: Cervical spondylotic myelopathy patients who underwent two levels anterior cervical discectomy and fixation (ACDF) or one level Anterior cervical corpectomy and fixation (ACCF) between 2007 and 2010 were recruited for this study. Before and 6 months after surgery, patient satisfaction was scaled on 5-point Likert scales. Neck pain, segmental height, and fusion rate were assessed radiographically before and immediately and after 6 months after surgery. Results: Twenty one patients with ACDF and 10 patients with ACCF were included. Age, sex, symptoms, radiographic data, operation duration, and complications were similar between the two groups but the blood loss was less in the ACDF group (P< 0.034). Postoperative mean segmental height was greater for ACDF (P=0.003) than for ACCF. Fusion rates for ACDF were 20 patients sound fusion (95.2%), and for ACCF were 9 patients sound fusion (90%). The 6-month follow up surgical outcomes were almost similar in both groups, and 61.2% had a good outcome (operation helped/helped a lot), 85.7% and 80% were satisfied/very satisfied with care. Improvement in the intensity of pain was marked in both groups with almost equal results on the pain scale. Conclusion: Cervical myelopathy treated either by ACDF or ACCF is considered an effective treatment with good long term outcome. ACDF has a less blood loss and a better fusion rate yet both techniques are giving satisfactory results for the patient regarding clinical outcome and pain levels. (2013ESJ039)
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