Outcome of Anterior Cervical Discectomy and Fusion Using Surgical Loupe

Abstract

Background Data: ACDF using the surgical microscope is the gold standard treatment for cervical radiculopathy, myelopathy or myeloradiculopathy due to herniated cervical disc and/or uncovertebral spurs, since it was first developed in 1950. Complications of ACDF, reported in the literature, have very low incidence rate except laryngeal and pharyngeal complications (dysphagia, dysphonia) with reported incidence of 5.7% to 93.3%. Purpose: To find out the possibility and safety of use of surgical loupe alone as an alternative to the gold standard surgical microscope. Study Design: observational analytic retrospective study. Patients and Methods: Retrospective evaluation of outcome of 59 cases of surgically treated cervical disc disease done using surgical loupe alone instead of microscope in Ain Shams university hospitals. Results: The mean VAS of axial neck pain and radicular pain decreased significantly immediately postoperatively (P value 0.001>). Radicular weakness improved immediately postoperatively (P value 0.032). Myelopathy improved significantly after 1 month (P value 0.004).The overall satisfaction of patients was excellent in 47.4% (28 cases) and very good in 37.3% (22 cases) with overall highly satisfactory results 84.7% of patients. The mean interval to return to work after surgery (in months) was 1.98±0.55. The mean of operation time (in minutes) of ACDF was 112.71±44.55. Conclusion: Surgical loupe could be good alternative to microscope in ACDF in resources- limited centers. (2014ESJ075)

Keywords

• Anterior cervical discectomy and fusion (ACDF)
• Visual analogue score (VAS)
• axial neck pain
• radicular pain
• radicular weakness
• myelopathy