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Outcomes of anterior cervical discectomy and fusion without fixation: a single surgeon's experience
EANS Academy. ELGHAMRY A. Sep 27, 2019; 276092; EP02073
Abstract
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Introduction: Anterior cervical discectomy and fusion (ACDF) is a successful technique for decompression in cases associated with anterior compression of the cervical spine. There has been debate about the necessity of using instrumentation fusion in multilevel cases to enhance fusion. In this study we report the outcome of ACDF operations in our hospital.
Method: This is a retrospective analysis of patients who underwent one to three levels ACDF without instrumental fusion in Newcastle upon Tyne Hospitals. All operations were performed by a single surgeon during the period 2014 to 2018. By studying our online hospital database (which includes outpatient letters, clinical documentation, patient's clinical notes and radiology reports) we looked at clinical outcome, recurrence rate, postoperative complications and return to theatre rates.
Results: During the specified period 340 patients underwent ACDF procedure for one to three level operation without fixation performed under the care of a single surgeon. All patients had a minimum follow up of three months period. In 293 patients (86.2%) had no pain or minimal pain following the surgery and 47 patients needed second surgery (13.8%) due to ineffective decompression 13 (3.4%) or adjacent level disease 32(9.4%). We had two cases of postoperative vertebral collapse (0.6%), one was managed conservatively, and the other one required reoperation through anterior and posterior fusion.
Conclusion: In our series, the results of performing ACDF alone without fixation in cases required single level or multilevel fusion was enough with minimal complication rate and good fusion rate. The need for re-operation in such cases was also low. In accordance with the international literature we can state that the outcome of ACDF operations is independent from plate fixation.
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