Long-term outcome following three-level stand-alone anterior cervical discectomy and fusion: Is plating necessary?
Background: Anterior cervical discectomy with fusion (ACDF) is a proven method for the treatment of selected patients. The necessity of use of an anterior plate is controversial. The article aims to assess the fusion rates (FRs) and long-term outcomes following three-level ACDF. Materials and Method...
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| Veröffentlicht in: | Asian journal of neurosurgery 2020-07, Vol.15 (3), p.554-559 |
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| creator | Theologou, Marios Theologou, Theologos Skoulios, Nikolaos Mitka, Maria Karanikolas, Nikolaos Theologou, Antriana Georgiou, Eleftheria Matejic, Slavisa Tsonidis, Christos |
| description | Background:
Anterior cervical discectomy with fusion (ACDF) is a proven method for the treatment of selected patients. The necessity of use of an anterior plate is controversial. The article aims to assess the fusion rates (FRs) and long-term outcomes following three-level ACDF.
Materials and Methods:
Data were collected from the medical records of patients operated on due to degenerative cervical disease. All patients were treated with three-level ACDF employing polyether ether-ketone cages without anterior plating. Visual analog scale (VAS), neck disability index (NDI), and plain radiographs were used in the clinical and radiological postsurgery assessment. Fusion evaluation was performed according to the |
| doi_str_mv | 10.4103/ajns.AJNS_196_19 |
| format | Article |
| fullrecord | <record><control><sourceid>gale_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7591186</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A634275889</galeid><sourcerecordid>A634275889</sourcerecordid><originalsourceid>FETCH-LOGICAL-c409n-b6e099bf7c9cd37ba8c7baca368cf6bc6cdcd8eb2190764432a9b7e06e118e783</originalsourceid><addsrcrecordid>eNp1kt1r2zAUxc3YWEPX9z0Nw2DsxalkS7K1h41Q9tERtod1z0KWrxOlspRKckL_-ykkDQmsMpLB93cOV9cny95iNCUYVddyZcN09vPXH4E5S_tFNilL0hScYfIym-CaVwUlTXmRXYWwQmlRTCkqX2cXVYUJLRGbZH7u7KKI4IfcjVG5AfLeGeO22i7yuPQAhYENmDxEabtCGmchlzYJtPO5Ar_RSpq800GBim54TMUu78egnf2U34Z8bWTceVlQEIL0j1_eZK96aQJcHd6X2d9vX-9ufhTz399vb2bzQhHEbdEyQJy3fa246qq6lY1Kh5IVa1TPWsVUp7oG2hJzVDNCqlLytgbEAOMG6qa6zD7vfddjO0CnwEYvjVh7PaQ2hJNanFesXoqF24ia8mTBksHHg4F3DyOEKIbdNY2RFtwYRElozTiqEE3o-z26kAaEtr1LjmqHixmrSFnTpuGJmv6HSk8Hg1Zpsr1O388EH04ES5AmLoMzY0zTDecg2oPKuxA89MdrYiR2aRG7tIiTtCTJu9PxHAVP2UjA3R7YOpP-d7g34xa8SOy9ddtnjQWlRBxTJQ6pEk-pSrbXe9u41JAKKzd6m3LwfKf_ABHf7HA</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2457690305</pqid></control><display><type>article</type><title>Long-term outcome following three-level stand-alone anterior cervical discectomy and fusion: Is plating necessary?</title><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>PubMed Central</source><source>PubMed Central Open Access</source><source>Thieme Connect Journals Open Access</source><creator>Theologou, Marios ; Theologou, Theologos ; Skoulios, Nikolaos ; Mitka, Maria ; Karanikolas, Nikolaos ; Theologou, Antriana ; Georgiou, Eleftheria ; Matejic, Slavisa ; Tsonidis, Christos</creator><creatorcontrib>Theologou, Marios ; Theologou, Theologos ; Skoulios, Nikolaos ; Mitka, Maria ; Karanikolas, Nikolaos ; Theologou, Antriana ; Georgiou, Eleftheria ; Matejic, Slavisa ; Tsonidis, Christos</creatorcontrib><description>Background:
Anterior cervical discectomy with fusion (ACDF) is a proven method for the treatment of selected patients. The necessity of use of an anterior plate is controversial. The article aims to assess the fusion rates (FRs) and long-term outcomes following three-level ACDF.
Materials and Methods:
Data were collected from the medical records of patients operated on due to degenerative cervical disease. All patients were treated with three-level ACDF employing polyether ether-ketone cages without anterior plating. Visual analog scale (VAS), neck disability index (NDI), and plain radiographs were used in the clinical and radiological postsurgery assessment. Fusion evaluation was performed according to the <1 mm motion between spinous processes rule. Subsidence was defined as a more than 2 mm decrease in the interbody height.
Results:
A total of 234 treated levels on 78 patients were assessed. The mean presurgery NDI score was 23.07 ± 4.86, with a mean disability of 46.03% ± 9.64. The mean presurgery VAS score of the neck was 7.58 ± 0.85, while VAS score of the arm was 7.75 ± 1.008. Post surgery, NDI stated no disability, while VAS score of the neck and arm showed no presence of pain. The mean FR was 19.50 ± 21.71 levels per month, with a peak from 3
rd
to 6
th
month. Presurgery evaluation showed 12 (15.38%) patients with a high T2 sequence signal. Magnetic resonance imaging screening detected 31 (39.24%) patients with coexisting cervical and lumbar findings. Post surgery, transient dysphagia was reported by 1 patient (1.28%), while subsidence was registered in 15 (6.41%) levels, situated in 12 patients (15.38%), most often at C
6-7
(66.6%). Clinical and radiological follow-up extended to 69.47 ± 11.45 months.
Conclusion:
Multilevel stand-alone ACDF is a safe, cost-effective procedure providing favorable clinical and radiological results with minimal complications. The incidence of subsidence is usually clinically insignificant and can be decreased with a careful surgical technique.</description><identifier>ISSN: 1793-5482</identifier><identifier>EISSN: 2248-9614</identifier><identifier>DOI: 10.4103/ajns.AJNS_196_19</identifier><identifier>PMID: 33145206</identifier><language>eng</language><publisher>A-12, 2nd Floor, Sector 2, Noida-201301 UP, India: Thieme Medical and Scientific Publishers Pvt. Ltd</publisher><subject>Medical records ; Original ; Original Article</subject><ispartof>Asian journal of neurosurgery, 2020-07, Vol.15 (3), p.554-559</ispartof><rights>Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon.</rights><rights>Copyright: © 2020 Asian Journal of Neurosurgery.</rights><rights>COPYRIGHT 2020 Medknow Publications and Media Pvt. Ltd.</rights><rights>Copyright: © 2020 Asian Journal of Neurosurgery 2020</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7591186/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7591186/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,881,20870,27901,27902,53766,53768,54562,54590</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33145206$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Theologou, Marios</creatorcontrib><creatorcontrib>Theologou, Theologos</creatorcontrib><creatorcontrib>Skoulios, Nikolaos</creatorcontrib><creatorcontrib>Mitka, Maria</creatorcontrib><creatorcontrib>Karanikolas, Nikolaos</creatorcontrib><creatorcontrib>Theologou, Antriana</creatorcontrib><creatorcontrib>Georgiou, Eleftheria</creatorcontrib><creatorcontrib>Matejic, Slavisa</creatorcontrib><creatorcontrib>Tsonidis, Christos</creatorcontrib><title>Long-term outcome following three-level stand-alone anterior cervical discectomy and fusion: Is plating necessary?</title><title>Asian journal of neurosurgery</title><addtitle>Asian J Neurosurg</addtitle><description>Background:
Anterior cervical discectomy with fusion (ACDF) is a proven method for the treatment of selected patients. The necessity of use of an anterior plate is controversial. The article aims to assess the fusion rates (FRs) and long-term outcomes following three-level ACDF.
Materials and Methods:
Data were collected from the medical records of patients operated on due to degenerative cervical disease. All patients were treated with three-level ACDF employing polyether ether-ketone cages without anterior plating. Visual analog scale (VAS), neck disability index (NDI), and plain radiographs were used in the clinical and radiological postsurgery assessment. Fusion evaluation was performed according to the <1 mm motion between spinous processes rule. Subsidence was defined as a more than 2 mm decrease in the interbody height.
Results:
A total of 234 treated levels on 78 patients were assessed. The mean presurgery NDI score was 23.07 ± 4.86, with a mean disability of 46.03% ± 9.64. The mean presurgery VAS score of the neck was 7.58 ± 0.85, while VAS score of the arm was 7.75 ± 1.008. Post surgery, NDI stated no disability, while VAS score of the neck and arm showed no presence of pain. The mean FR was 19.50 ± 21.71 levels per month, with a peak from 3
rd
to 6
th
month. Presurgery evaluation showed 12 (15.38%) patients with a high T2 sequence signal. Magnetic resonance imaging screening detected 31 (39.24%) patients with coexisting cervical and lumbar findings. Post surgery, transient dysphagia was reported by 1 patient (1.28%), while subsidence was registered in 15 (6.41%) levels, situated in 12 patients (15.38%), most often at C
6-7
(66.6%). Clinical and radiological follow-up extended to 69.47 ± 11.45 months.
Conclusion:
Multilevel stand-alone ACDF is a safe, cost-effective procedure providing favorable clinical and radiological results with minimal complications. The incidence of subsidence is usually clinically insignificant and can be decreased with a careful surgical technique.</description><subject>Medical records</subject><subject>Original</subject><subject>Original Article</subject><issn>1793-5482</issn><issn>2248-9614</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>0U6</sourceid><recordid>eNp1kt1r2zAUxc3YWEPX9z0Nw2DsxalkS7K1h41Q9tERtod1z0KWrxOlspRKckL_-ykkDQmsMpLB93cOV9cny95iNCUYVddyZcN09vPXH4E5S_tFNilL0hScYfIym-CaVwUlTXmRXYWwQmlRTCkqX2cXVYUJLRGbZH7u7KKI4IfcjVG5AfLeGeO22i7yuPQAhYENmDxEabtCGmchlzYJtPO5Ar_RSpq800GBim54TMUu78egnf2U34Z8bWTceVlQEIL0j1_eZK96aQJcHd6X2d9vX-9ufhTz399vb2bzQhHEbdEyQJy3fa246qq6lY1Kh5IVa1TPWsVUp7oG2hJzVDNCqlLytgbEAOMG6qa6zD7vfddjO0CnwEYvjVh7PaQ2hJNanFesXoqF24ia8mTBksHHg4F3DyOEKIbdNY2RFtwYRElozTiqEE3o-z26kAaEtr1LjmqHixmrSFnTpuGJmv6HSk8Hg1Zpsr1O388EH04ES5AmLoMzY0zTDecg2oPKuxA89MdrYiR2aRG7tIiTtCTJu9PxHAVP2UjA3R7YOpP-d7g34xa8SOy9ddtnjQWlRBxTJQ6pEk-pSrbXe9u41JAKKzd6m3LwfKf_ABHf7HA</recordid><startdate>20200701</startdate><enddate>20200701</enddate><creator>Theologou, Marios</creator><creator>Theologou, Theologos</creator><creator>Skoulios, Nikolaos</creator><creator>Mitka, Maria</creator><creator>Karanikolas, Nikolaos</creator><creator>Theologou, Antriana</creator><creator>Georgiou, Eleftheria</creator><creator>Matejic, Slavisa</creator><creator>Tsonidis, Christos</creator><general>Thieme Medical and Scientific Publishers Pvt. Ltd</general><general>Wolters Kluwer India Pvt. Ltd</general><general>Medknow Publications and Media Pvt. Ltd</general><general>Wolters Kluwer - Medknow</general><scope>0U6</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20200701</creationdate><title>Long-term outcome following three-level stand-alone anterior cervical discectomy and fusion: Is plating necessary?</title><author>Theologou, Marios ; Theologou, Theologos ; Skoulios, Nikolaos ; Mitka, Maria ; Karanikolas, Nikolaos ; Theologou, Antriana ; Georgiou, Eleftheria ; Matejic, Slavisa ; Tsonidis, Christos</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c409n-b6e099bf7c9cd37ba8c7baca368cf6bc6cdcd8eb2190764432a9b7e06e118e783</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Medical records</topic><topic>Original</topic><topic>Original Article</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Theologou, Marios</creatorcontrib><creatorcontrib>Theologou, Theologos</creatorcontrib><creatorcontrib>Skoulios, Nikolaos</creatorcontrib><creatorcontrib>Mitka, Maria</creatorcontrib><creatorcontrib>Karanikolas, Nikolaos</creatorcontrib><creatorcontrib>Theologou, Antriana</creatorcontrib><creatorcontrib>Georgiou, Eleftheria</creatorcontrib><creatorcontrib>Matejic, Slavisa</creatorcontrib><creatorcontrib>Tsonidis, Christos</creatorcontrib><collection>Thieme Connect Journals Open Access</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Asian journal of neurosurgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Theologou, Marios</au><au>Theologou, Theologos</au><au>Skoulios, Nikolaos</au><au>Mitka, Maria</au><au>Karanikolas, Nikolaos</au><au>Theologou, Antriana</au><au>Georgiou, Eleftheria</au><au>Matejic, Slavisa</au><au>Tsonidis, Christos</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Long-term outcome following three-level stand-alone anterior cervical discectomy and fusion: Is plating necessary?</atitle><jtitle>Asian journal of neurosurgery</jtitle><addtitle>Asian J Neurosurg</addtitle><date>2020-07-01</date><risdate>2020</risdate><volume>15</volume><issue>3</issue><spage>554</spage><epage>559</epage><pages>554-559</pages><issn>1793-5482</issn><eissn>2248-9614</eissn><abstract>Background:
Anterior cervical discectomy with fusion (ACDF) is a proven method for the treatment of selected patients. The necessity of use of an anterior plate is controversial. The article aims to assess the fusion rates (FRs) and long-term outcomes following three-level ACDF.
Materials and Methods:
Data were collected from the medical records of patients operated on due to degenerative cervical disease. All patients were treated with three-level ACDF employing polyether ether-ketone cages without anterior plating. Visual analog scale (VAS), neck disability index (NDI), and plain radiographs were used in the clinical and radiological postsurgery assessment. Fusion evaluation was performed according to the <1 mm motion between spinous processes rule. Subsidence was defined as a more than 2 mm decrease in the interbody height.
Results:
A total of 234 treated levels on 78 patients were assessed. The mean presurgery NDI score was 23.07 ± 4.86, with a mean disability of 46.03% ± 9.64. The mean presurgery VAS score of the neck was 7.58 ± 0.85, while VAS score of the arm was 7.75 ± 1.008. Post surgery, NDI stated no disability, while VAS score of the neck and arm showed no presence of pain. The mean FR was 19.50 ± 21.71 levels per month, with a peak from 3
rd
to 6
th
month. Presurgery evaluation showed 12 (15.38%) patients with a high T2 sequence signal. Magnetic resonance imaging screening detected 31 (39.24%) patients with coexisting cervical and lumbar findings. Post surgery, transient dysphagia was reported by 1 patient (1.28%), while subsidence was registered in 15 (6.41%) levels, situated in 12 patients (15.38%), most often at C
6-7
(66.6%). Clinical and radiological follow-up extended to 69.47 ± 11.45 months.
Conclusion:
Multilevel stand-alone ACDF is a safe, cost-effective procedure providing favorable clinical and radiological results with minimal complications. The incidence of subsidence is usually clinically insignificant and can be decreased with a careful surgical technique.</abstract><cop>A-12, 2nd Floor, Sector 2, Noida-201301 UP, India</cop><pub>Thieme Medical and Scientific Publishers Pvt. Ltd</pub><pmid>33145206</pmid><doi>10.4103/ajns.AJNS_196_19</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| source | Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central; PubMed Central Open Access; Thieme Connect Journals Open Access |
| subjects | Medical records Original Original Article |
| title | Long-term outcome following three-level stand-alone anterior cervical discectomy and fusion: Is plating necessary? |
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