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Long-term outcome after anterior cervical discectomy without fusion.

Nandoe Tewarie RD, Bartels RH, Peul WC - Eur Spine J (2007)

Bottom Line: Two months post-operative follow up at the outpatient clinic revealed that 90.1% of patients were satisfied with the result of ACD surgery.On the short term, ACD leads to a satisfied outcome.The increase in complaints at the time of the survey may be the result of ongoing degenerative effects.

View Article: PubMed Central - PubMed

Affiliation: University Medical Center Nijmegen, Neurosurgery, R. Postlaan 4, 6500 HB, Nijmegen, Gelderland, The Netherlands. R.D.S.Nandoe@nch.umcn.nl

ABSTRACT
To retrospectively study the long-term outcome of patients after anterior cervical discectomy without fusion (ACD) compared to results published on the long-term outcome after ACD with fusion (ACDF). We reviewed the charts of all patients receiving ACD surgery between 1985 and 2000 to analyze the direct post-operative results as well as complications of the surgery. Moreover, 102 patients, randomly selected, were interviewed with the neck disability index to study possible persisting complaints up to 18 years after ACD surgery. A total of 551 Patients were identified. Two months post-operative follow up at the outpatient clinic revealed that 90.1% of patients were satisfied with the result of ACD surgery. At the time of the survey, this percentage had dropped to 67.6%. In addition, 20.6% and 11.8% had obtained moderate to severe complaints, respectively, in daily-life activities. Complaints were mainly localized in the neck region and occasionally provoked radiating pain in the arm. On the short term, ACD leads to a satisfied outcome. Over the longer term, patients report increasing complaints. The increase in complaints at the time of the survey may be the result of ongoing degenerative effects. Compared to published data on ACDF, there is no superiority of any fusion technique compared to ACD alone.

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Average neck disability scores of patients with good or moderate to severe outcomes at the time of the survey related to the year of surgery. In blue the average scores of moderate to severe patients for each year of surgery between 1985 and 2000 and in black a trend line was added to reveal an increase in complaints after a longer follow up period after single level anterior cervical spine surgery. In pink the average scores of patients with a good outcome. Between brackets are the total years of follow up at the time of the survey
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Fig1: Average neck disability scores of patients with good or moderate to severe outcomes at the time of the survey related to the year of surgery. In blue the average scores of moderate to severe patients for each year of surgery between 1985 and 2000 and in black a trend line was added to reveal an increase in complaints after a longer follow up period after single level anterior cervical spine surgery. In pink the average scores of patients with a good outcome. Between brackets are the total years of follow up at the time of the survey

Mentions: Patients with a good outcome were found at all follow up periods, without a clear preference (Fig. 1). Evaluation of the moderate and severe complaints in time showed that this group of patients increased their complaints in time after surgery. Figure 1 shows a graph of the average NDI score for each year of surgery. In Table 4, the mean NDI score has been calculated in brackets of 5-year follow-up. The table does not show a clear deterioration in complaints over time, however, by adding a trend line in the graph it becomes clear that there is an increase in complaints with an increase of follow-up time after surgery. The line drops 10 points in NDI score over the 15 years of follow up, which means that each year an increase of 0.67 points in complaints can be estimated (Fig. 1 and Table 4).Fig. 1


Long-term outcome after anterior cervical discectomy without fusion.

Nandoe Tewarie RD, Bartels RH, Peul WC - Eur Spine J (2007)

Average neck disability scores of patients with good or moderate to severe outcomes at the time of the survey related to the year of surgery. In blue the average scores of moderate to severe patients for each year of surgery between 1985 and 2000 and in black a trend line was added to reveal an increase in complaints after a longer follow up period after single level anterior cervical spine surgery. In pink the average scores of patients with a good outcome. Between brackets are the total years of follow up at the time of the survey
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2200758&req=5

Fig1: Average neck disability scores of patients with good or moderate to severe outcomes at the time of the survey related to the year of surgery. In blue the average scores of moderate to severe patients for each year of surgery between 1985 and 2000 and in black a trend line was added to reveal an increase in complaints after a longer follow up period after single level anterior cervical spine surgery. In pink the average scores of patients with a good outcome. Between brackets are the total years of follow up at the time of the survey
Mentions: Patients with a good outcome were found at all follow up periods, without a clear preference (Fig. 1). Evaluation of the moderate and severe complaints in time showed that this group of patients increased their complaints in time after surgery. Figure 1 shows a graph of the average NDI score for each year of surgery. In Table 4, the mean NDI score has been calculated in brackets of 5-year follow-up. The table does not show a clear deterioration in complaints over time, however, by adding a trend line in the graph it becomes clear that there is an increase in complaints with an increase of follow-up time after surgery. The line drops 10 points in NDI score over the 15 years of follow up, which means that each year an increase of 0.67 points in complaints can be estimated (Fig. 1 and Table 4).Fig. 1

Bottom Line: Two months post-operative follow up at the outpatient clinic revealed that 90.1% of patients were satisfied with the result of ACD surgery.On the short term, ACD leads to a satisfied outcome.The increase in complaints at the time of the survey may be the result of ongoing degenerative effects.

View Article: PubMed Central - PubMed

Affiliation: University Medical Center Nijmegen, Neurosurgery, R. Postlaan 4, 6500 HB, Nijmegen, Gelderland, The Netherlands. R.D.S.Nandoe@nch.umcn.nl

ABSTRACT
To retrospectively study the long-term outcome of patients after anterior cervical discectomy without fusion (ACD) compared to results published on the long-term outcome after ACD with fusion (ACDF). We reviewed the charts of all patients receiving ACD surgery between 1985 and 2000 to analyze the direct post-operative results as well as complications of the surgery. Moreover, 102 patients, randomly selected, were interviewed with the neck disability index to study possible persisting complaints up to 18 years after ACD surgery. A total of 551 Patients were identified. Two months post-operative follow up at the outpatient clinic revealed that 90.1% of patients were satisfied with the result of ACD surgery. At the time of the survey, this percentage had dropped to 67.6%. In addition, 20.6% and 11.8% had obtained moderate to severe complaints, respectively, in daily-life activities. Complaints were mainly localized in the neck region and occasionally provoked radiating pain in the arm. On the short term, ACD leads to a satisfied outcome. Over the longer term, patients report increasing complaints. The increase in complaints at the time of the survey may be the result of ongoing degenerative effects. Compared to published data on ACDF, there is no superiority of any fusion technique compared to ACD alone.

Show MeSH
Related in: MedlinePlus