ORIGINAL ARTICLE
Year : 2012  |  Volume : 5  |  Issue : 1  |  Page : 31-35

Treatment of cervical radiculopathy by anterior cervical discectomy and cage fusion


1 Department of Orthopedic Surgery, Al-Azhar University, Damietta, Egypt
2 Department of Neuro Surgery, Al-Azhar University, Damietta, Egypt

Correspondence Address:
Osman A Mohamed
Department of Orthopedic Surgery, Al-Azhar University, Damietta
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0975-2870.97509

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Introduction: Since the pioneering days of the anterior cervical approach introduced by Cloward et al. in the early 1950s, anterior cervical discectomy and fusion (ACDF) has been the standard procedure for most discogenic and degenerative cervical spinal lesions. Although traditional interbody fusion using iliac bone can maintain the patency of the neuroforamen and ensure solid fusion, selection of patients, and of surgical procedure for ACDF is a continuous challenge. Aim: The aim of this study was to assess the results of cervical discectomy and fusion with cervical cages in treatment of cervical radiculopathy clinically and radiologically. Materials and Methods: Eighteen patients suffering from cervical radiculopathy were operated upon using this technique. They were 15 males and 3 females. Clinical and radiological assessment, visual analog scale (VAS) for neck and arm and modified Oswestery neck disability index (NDI) were done preoperatively and at 4 weeks, 3, 6, and 12 months postoperatively. Polyetheretherketone (Peek) cages filled with iliac bone graft were used after cervical discectomy. The levels operated upon were C 5-6 in 16 patients and C4-5 in 2 patients. Results: Marked clinical improvement as regard arm and neck pain, and NDI was observed. The pre and post operative mean and standard deviations (SD) of the various scores were as follows. VAS for pain in arm reduced from mean of 8 (SD 1.76) to mean 0.4 (SD 0.4), VAS for neck pain reduced from mean of 3.5 (SD 1.58) to mean of 0.8 (SD 0.47), and NDI from mean of 20.2 (SD 0.89) to 2.1(SD 1.05). Fusion occurred in all patients. Subjectively 79% of the patients reported marked improvement in neck pain, and 95% reported marked reduction in arm pain. Conclusion: Anterior cervical discectomy and cage fusion resulted in high fusion rate with minimal preservation of lordosis.


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