A single-center retrospective analysis of 3- or 4-level anterior cervical discectomy and fusion: surgical outcomes in 66 patients.
| dc.contributor.author | McClure, Jesse J | |
| dc.contributor.author | Desai, Bhargav D | |
| dc.contributor.author | Shabo, Leah M | |
| dc.contributor.author | Buell, Thomas J | |
| dc.contributor.author | Yen, Chun-Po | |
| dc.contributor.author | Smith, Justin S | |
| dc.contributor.author | Shaffrey, Christopher I | |
| dc.contributor.author | Shaffrey, Mark E | |
| dc.contributor.author | Buchholz, Avery L | |
| dc.date.accessioned | 2023-06-19T19:45:57Z | |
| dc.date.available | 2023-06-19T19:45:57Z | |
| dc.date.issued | 2020-10 | |
| dc.date.updated | 2023-06-19T19:45:56Z | |
| dc.description.abstract | ObjectiveAnterior cervical discectomy and fusion (ACDF) is a safe and effective intervention to treat cervical spine pathology. Although these were originally performed as single-level procedures, multilevel ACDF has been performed for patients with extensive degenerative disc disease. To date, there is a paucity of data regarding outcomes related to ACDFs of 3 or more levels. The purpose of this study was to compare surgical outcomes of 3- and 4-level ACDF procedures.MethodsThe authors performed a retrospective chart review of patients who underwent 3- and 4-level ACDF at the University of Virginia Health System between January 2010 and December 2017. In patients meeting the inclusion/exclusion criteria, demographics, fusion rates, time to fusion, and reoperation rates were evaluated. Fusion was determined by < 1 mm of change in interspinous distance between individual fused vertebrae on lateral flexion/extension radiographs and lack of radiolucency between the grafts and vertebral bodies. Any procedure requiring a surgical revision was considered a failure.ResultsSixty-six patients (47 with 3-level and 19 with 4-level ACDFs) met the inclusion/exclusion criteria of having at least one lateral flexion/extension radiograph series ≥ 12 months after surgery. Seventy percent of 3-level patients and 68% of 4-level patients had ≥ 24 months of follow-up. Ninety-four percent of 3-level patients and 100% of 4-level patients achieved radiographic fusion for at least 1 surgical level. Eighty-eight percent and 82% of 3- and 4-level patients achieved fusion at C3-4; 85% and 89% of 3- and 4-level patients achieved fusion at C4-5; 68% and 89% of 3- and 4-level patients achieved fusion at C5-6; 44% and 42% of 3- and 4-level patients achieved fusion at C6-7; and no patients achieved fusion at C7-T1. Time to fusion was not significantly different between levels. Revision was required in 6.4% of patients with 3-level and in 16% of patients with 4-level ACDF. The mean time to revision was 46.2 and 45.4 months for 3- and 4-level ACDF, respectively. The most common reason for revision was worsening of initial symptoms.ConclusionsThe authors' experience with long-segment anterior cervical fusions shows their fusion rates exceeding most of the reported fusion rates for similar procedures in the literature, with rates similar to those reported for short-segment ACDFs. Three-level and 4-level ACDF procedures are viable options for cervical spine pathology, and the authors' analysis demonstrates an equivalent rate of fusion and time to fusion between 3- and 4-level surgeries. | |
| dc.identifier | 2020.6.SPINE20171 | |
| dc.identifier.issn | 1547-5654 | |
| dc.identifier.issn | 1547-5646 | |
| dc.identifier.uri | ||
| dc.language | eng | |
| dc.publisher | Journal of Neurosurgery Publishing Group (JNSPG) | |
| dc.relation.ispartof | Journal of neurosurgery. Spine | |
| dc.relation.isversionof | 10.3171/2020.6.spine20171 | |
| dc.subject | 3 levels | |
| dc.subject | 4 levels | |
| dc.subject | ACDF | |
| dc.subject | ACDF = anterior cervical discectomy and fusion | |
| dc.subject | PSIF = posterior spinal instrumentation and fusion | |
| dc.subject | anterior cervical discectomy and fusion | |
| dc.subject | fusion | |
| dc.subject | time to fusion | |
| dc.title | A single-center retrospective analysis of 3- or 4-level anterior cervical discectomy and fusion: surgical outcomes in 66 patients. | |
| dc.type | Journal article | |
| duke.contributor.orcid | Shaffrey, Christopher I|0000-0001-9760-8386 | |
| pubs.begin-page | 1 | |
| pubs.end-page | 7 | |
| pubs.issue | 1 | |
| pubs.organisational-group | Duke | |
| pubs.organisational-group | School of Medicine | |
| pubs.organisational-group | Clinical Science Departments | |
| pubs.organisational-group | Orthopaedic Surgery | |
| pubs.organisational-group | Neurosurgery | |
| pubs.publication-status | Published | |
| pubs.volume | 34 |
Files
Original bundle
1 - 1 of 1
Loading...
- Name:
- A single-center retrospective analysis of 3- or 4-level anterior cervical discectomy and fusion_ surgical outcomes in 66 patients.pdf
- Size:
- 1.9 MB
- Format:
- Adobe Portable Document Format