Cervical alignment and clinical outcome of anterior cervical discectomy and fusion vs. anterior cervical corpectomy and fusion in local kyphotic cervical spondylotic myelopathy

Du, Wei; Wang, Haixu; Lü, Jie; Wang, Shuai; Shen, Yong; Zhang, Xu; Chen, Rong; Zhang, Li

doi:10.1016/j.heliyon.2023.e19106

Cited by 4 publications

(2 citation statements)

References 42 publications

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“…These symptoms signi cantly impact patients' quality of life and frequently necessitate surgical intervention. [1,2] Anterior cervical discectomy and fusion (ACDF) represents a conventional approach for managing CSM, entailing the excision of diseased intervertebral discs and bony structures to achieve comprehensive decompression of the spinal cord and/or nerve roots, as well as recti cation of the physiological curvature of the cervical spine and restoration of the localized sagittal alignment [3,4] Nevertheless, despite its established role, there is a plethora of literature documenting unfavorable clinical prognosis following ACDF [5] which markedly diminishes patients' quality of life and frequently mandates further surgical intervention. Moreover, the impact of individual factors on surgical outcomes remains a subject of ongoing debate.…”

Section: Introductionmentioning

confidence: 99%

Risk factors for poor neurological recovery after anterior cervical discectomy and fusion: imaging characteristics

lu,

zhang,

chai

et al. 2024

Preprint

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Background:Poor neurological recovery in patients after anterior cervical discectomy and fusion has been frequently reported; however, there are no studies that analyze the preoperative imaging characteristics of patients to investigate the factors affecting surgical prognosis. The purpose of this study was to investigate the factors influencing patients' preoperative imaging characteristics on poor neurologic recovery after anterior cervical discectomy and fusion. Methods We retrospectively analyzed the clinical data of 89 patients who met the criteria for anterior cervical discectomy and fusion for the treatment of single-level cervical spondylotic myelopathy and evaluated the patients' neurological recovery based on the recovery rate of the Japanese Orthopaedic Association (JOA) scores at the time of the final follow-up visit;patients were categorized into "good" and "poor" groups based on JOA recovery rates of ≥ 50% and < 50%, respectively. Clinical information (age, gender, body mass index, duration of symptoms, JOA score preoperative and at the final follow-up), and imaging characteristics (cervical kyphosis, cervical instability, ossification of the posterior longitudinal ligament(OPLL), calcification of herniated intervertebral discs, increased signal intensity(ISI) of the spinal cord on T2WI, and degree of degeneration of the discs adjacent to the fused levels (cranial and caudal) were collected from the patients.) Univariate and binary logistic regression analyses were used to identify risk factors for poor neurologic recovery. Results The mean age of the patients was 52.56 ± 11.18 years, and the mean follow-up was 26.89±11.14 months. 20 patients (22.5%) had poor neurological recovery. Univariate analysis showed that significant predictors of poor neurological recovery were age (p = 0.019), concomitant OPLL (p = 0.019), concomitant calcification of herniated intervertebral discs (p = 0.019), ISI of the spinal cord on T2WI (p ＜0.05), a high grade of degeneration of the discs of the cranial neighboring levels (p ＜0.05), and a high grade of discs of the caudal neighboring levels (p ＜0.05). Binary logistic regression analysis showed that ISI of the spinal cord on T2WI (p = 0.001 OR = 24.947), and high degree of degeneration of adjacent discs on the cranial side (p = 0.040 OR = 6.260) were independent risk factors for poor neurological prognosis. Conclusion ISI of the spinal cord on T2WI and high degree of cranial adjacent disc degeneration are independent risk factors for poor neurological recovery after anterior cervical discectomy and fusion, and comprehensive analysis of the patients' preoperative imaging characteristics can help in the development of surgical protocols and the management of patients' surgical expectations.

show abstract

Section: Introductionmentioning

confidence: 99%

Risk factors for poor neurological recovery after anterior cervical discectomy and fusion: imaging characteristics

lu,

zhang,

chai

et al. 2024

Preprint

View full text Add to dashboard Cite

show abstract

“…Anterior cervical discectomy and fusion (ACDF) is a conventional approach for managing CSM. It involves the excision of diseased intervertebral discs and bony structures to relieve pressure on the spinal cord and/or nerve roots, as well as correct the physiological curvature of the cervical spine and restore the localized sagittal alignment [ 3 , 4 ]. Despite its established role, numerous studies have documented unfavorable clinical prognosis following ACDF [ 5 ], which markedly diminishes patients’ quality of life and frequently mandates further surgical intervention.…”

Section: Introductionmentioning

confidence: 99%

Risk factors for poor neurological recovery after anterior cervical discectomy and fusion: imaging characteristics

Lu,

Zhang,

Chai

et al. 2024

J Orthop Surg Res

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Background Poor neurological recovery in patients after anterior cervical discectomy and fusion has been frequently reported; however, no study has analyzed the preoperative imaging characteristics of patients to investigate the factors affecting surgical prognosis. The purpose of this study was to investigate the factors that affect the preoperative imaging characteristics of patients and their influence on poor neurologic recovery after anterior cervical discectomy and fusion. Methods We retrospectively analyzed the clinical data of 89 patients who met the criteria for anterior cervical discectomy and fusion for the treatment of single-level cervical spondylotic myelopathy and evaluated the patients’ neurological recovery based on the recovery rate of the Japanese Orthopaedic Association (JOA) scores at the time of the final follow-up visit. Patients were categorized into the “good” and “poor” groups based on the JOA recovery rates of ≥ 50% and < 50%, respectively. Clinical information (age, gender, body mass index, duration of symptoms, preoperative JOA score, and JOA score at the final follow-up) and imaging characteristics (cervical kyphosis, cervical instability, ossification of the posterior longitudinal ligament (OPLL), calcification of herniated intervertebral discs, increased signal intensity (ISI) of the spinal cord on T2-weighted imaging (T2WI), and degree of degeneration of the discs adjacent to the fused levels (cranial and caudal) were collected from the patients. Univariate and binary logistic regression analyses were performed to identify risk factors for poor neurologic recovery. Results The mean age of the patients was 52.56 ± 11.18 years, and the mean follow-up was 26.89 ± 11.14 months. Twenty patients (22.5%) had poor neurological recovery. Univariate analysis showed that significant predictors of poor neurological recovery were age (p = 0.019), concomitant OPLL (p = 0.019), concomitant calcification of herniated intervertebral discs (p = 0.019), ISI of the spinal cord on T2WI (p <0.05), a high grade of degeneration of the discs of the cranial neighboring levels (p <0.05), and a high grade of discs of the caudal neighboring levels (p <0.05). Binary logistic regression analysis showed that ISI of the spinal cord on T2WI (p = 0.001 OR = 24.947) and high degree of degeneration of adjacent discs on the cranial side (p = 0.040 OR = 6.260) were independent risk factors for poor neurological prognosis. Conclusion ISI of the spinal cord on T2WI and high degree of cranial adjacent disc degeneration are independent risk factors for poor neurological recovery after anterior cervical discectomy and fusion. A comprehensive analysis of the patients’ preoperative imaging characteristics can help in the development of surgical protocols and the management of patients’ surgical expectations.

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Comparison between 3-level and 4-level anterior cervical discectomy and fusion in the treatment of cervical spondylotic myelopathy: A meta-analysis

Wang,

Long,

Guo

et al. 2023

Heliyon

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Cervical alignment and clinical outcome of anterior cervical discectomy and fusion vs. anterior cervical corpectomy and fusion in local kyphotic cervical spondylotic myelopathy

Cited by 4 publications

References 42 publications

Risk factors for poor neurological recovery after anterior cervical discectomy and fusion: imaging characteristics

Risk factors for poor neurological recovery after anterior cervical discectomy and fusion: imaging characteristics

Risk factors for poor neurological recovery after anterior cervical discectomy and fusion: imaging characteristics

Comparison between 3-level and 4-level anterior cervical discectomy and fusion in the treatment of cervical spondylotic myelopathy: A meta-analysis

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