Favourable long-term clinical outcome after anterior cervical discectomy. A study on a series of 125 patients undergoing surgery a mean of 11 years earlier

Palma, Lucio; Mariottini, Aldo; Carangelo, B; Muzii, Vitaliano Francesco; Zalaffi, Alessandro

doi:10.1007/s00701-010-0650-5

Cited by 17 publications

(22 citation statements)

References 45 publications

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“…In fact, it appears that disc space destruction correlates with spontaneous fusion. ACD leads to spontaneous bony fusion in 70-90 % of cases [17,18] as a result of ongoing degeneration, which is assumed to be related to long-term deterioration of the clinical outcome [19]. Although there is no direct comparison with ACD, AF seems to induce less same-level degeneration, much less spontaneous fusion, and thus less long-term deterioration in the clinical outcome (Fig.…”

Section: Discussionmentioning

confidence: 99%

Long-term outcomes following anterior foraminotomy for one- or two-level cervical radiculopathy

et al. 2013

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Purpose Anterior foraminotomy (AF) is a surgical treatment for unilateral cervical radiculopathy that avoids fusion-related complications, but its long-term outcome has yet to be investigated. To clarify the efficacy of AF, the author retrospectively collected long-term data regarding the results of this technique. Methods Of 50 patients who underwent AF between November 1999 and June 2005, those who were followed for more than 6 years (n = 44) were enrolled in this study. The parameters studied included the number of revisions, additional surgeries, VAS/NDI, and Odom's criteria. Plain radiographs were also obtained pre-and postoperatively. Results At discharge, 98 % of patients reported improvement, although 20 % temporarily experienced some residual symptoms. There were no other major postoperative complications. At final follow-up (FU, mean of 8.8 years), an excellent or good outcome was achieved in 39 patients (89 %). There was no index level reoperation required, but two additional operations for symptomatic adjacent-segment degeneration were needed (4.5 %). Six patients suffered from shoulder pain on the same side after surgery (mean onset: 3.6 years). At final FU, significant degeneration at the operated level was demonstrated on plain radiographs, resulting in a decreased range of motion. However, loss of lordosis of the segment was minimal. Radiographically, adjacent segment degeneration was noted in only 6 and 11 % at the cranial and caudal segments, respectively.Conclusions In this retrospective study, patients who underwent AF for one-or two-level cervical radiculopathy showed a good long-term outcome with minimal adjacent segment degeneration. However, more data should be collected to clarify possible associations with these findings, such as delayed shoulder problems and aggravation of degeneration at the operated level.

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Section: Discussionmentioning

confidence: 99%

Long-term outcomes following anterior foraminotomy for one- or two-level cervical radiculopathy

et al. 2013

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“…As far as patients with degenerative changes in the cervical segment are concerned, Faldini [48] noticed that up to 75% of patients evaluated the results of treatment as good or excellent. Another study showed that the success rate can be even higher, with 96% of patients reporting improvement [49]. Such promising results may predominantly arise from shorter duration of pain symptoms prior to the procedure, particularly in the context of nerve root pain [50].…”

Section: Discussionmentioning

confidence: 99%

Assessment and Determinants of Spinal Pain in the Course of Disc Disorders Treated Surgically

et al. 2016

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BackgroundIntervertebral disc disease is defined as a complex of structural changes in the aftermath of disorders of mutual elements, the structure of which form the discus intervertebralis and the spinal canal. The present work assessed pain in patients who were surgically treated due to spinal discopathy and analyzed factors that determine the condition.Material/MethodsThe research was carried on a group of 187 patients diagnosed with discopathy of the lumbosacral and cervical segment. The data are discussed in the context of medical records and the Visual Analogue Scale used for pain assessment. We used a prospective study plan with a 3-time assessment.ResultsThe pain level observed among patients prior to the procedure (M=6.52) was higher than after 7 days (M=3.15) and 6 months from the operation (M= 3.45). The highest level of pain (M=6.88), with a relatively high consistency among the patients (SD=2.25), was observed in the case of left-side hernia (H=7.31; p=0.023). The influence of the analyzed factors on pain experience markedly increased by the third assessment (R2=0.14), and was strongly associated with the type of work performed by the patient.ConclusionsSurgical operation significantly reduces pain in patients with disc disorders. The level of pain is predominantly affected by the location of the hernia and the type of work performed by the patient.

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“…Faldini et al reported a series of 51 patients treated with anterior cervical discectomy and fusion followed for 10 years noting that over 75% of patients rated their outcome good to excellent according to Odom's criteria [30]. Another study of 125 patients followed for 11 years on average indicated a 96% favorable outcome with only 5 patients undergoing adjacent level surgery [31].…”

Section: Surgical Treatment Of Radiculopathymentioning

confidence: 97%

Cervical spine: degenerative conditions

Todd

2011

Curr Rev Musculoskelet Med

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Degenerative cervical spine disorders will affect up to two-thirds of the population in their lifetime. While often benign and episodic in nature, cervical disorders may become debilitating resulting in severe pain and possibly neurologic sequelae. Non-operative treatment continues to play an important role in treating these patients, with medications, therapy and interventional pain injections playing increasing roles in treatment. Surgical treatment including anterior and posterior decompression and fusion have been effective treatments of many cervical disorders, but may lead to significant problems including adjacent level disease. Laminotomy/foraminotomy and total disc arthroplasty may avoid some of these problems while providing similar clinical results. Ongoing clinical trials and studies are helping to define the role of these new technologies in treatment of patients with degenerative cervical disorders, although their greater benefit has yet to be proven.

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Favourable long-term clinical outcome after anterior cervical discectomy. A study on a series of 125 patients undergoing surgery a mean of 11 years earlier

Cited by 17 publications

References 45 publications

Long-term outcomes following anterior foraminotomy for one- or two-level cervical radiculopathy

Long-term outcomes following anterior foraminotomy for one- or two-level cervical radiculopathy

Assessment and Determinants of Spinal Pain in the Course of Disc Disorders Treated Surgically

Cervical spine: degenerative conditions

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