Long-term outcome after anterior cervical discectomy without fusion

Rishi D S Nandoe Tewarie, Ronald H M A Bartels, Wilco C Peul, Rishi D S Nandoe Tewarie, Ronald H M A Bartels, Wilco C Peul

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.

Figures

Fig. 1
Fig. 1
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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