Istanbul Spine Center Florence Nightingale Hospital Istanbul-TURKEY

SURGICAL TREATMENT OF CERVICAL DEGENERATIVE DISC DISEASE WITH

MYELORADICULOPATHY: TWO-LEVEL ANTERIOR DISCECTOMY VERSUS ONE LEVEL ANTERIOR

CORPECTOMY

Istanbul Spine CenterFlorence Nightingale Hospital

Istanbul-TURKEY

Ahmet ALANAY, MD

Kursat GANIYUSUFOGLU, MD

Selhan KARADERELER, MD

Mehmet AYDOGAN, MD

Cagatay OZTURK, MD

Azmi HAMZAOGLU, MD

PURPOSE The aim of this retrospective study is to compare two

fusion techniques with reference to perioperative and

radiological parameters and clinical outcomes.

MATERIALS & METHODS74 patients having surgery due to 2-level cervical

spondylotic myeloradiculopathy

Surgery;ACDF (two contiguous levels)

ACCF (single level including 2 disc spaces)

MATERIALS & METHODS

The perioperative parameters

Hospitalization

Blood loss

Operation times

Complications

The radiologic parameters

Cervical lordosis

Fusion rate

The clinical parameters

Visual Analog Scale

[VAS] scores of neck

and arm pain

RESULTSACDF ACCF

# of patients 47 27Mean age (y) 53.7 55.3

Male to Female ratio 21/26 11/16Mean F/U (m) 48.4 51.2

Perioperative parameters ACDF ACCF pHospitalization (day) 5.2 5.4 >0.05

Blood loss (cc) 283 342 >0.05Operation time (minutes) 180 210 >0.05

Complications* 4/47 2/27 >0.05

*ACDF: dura laceration in 1, hoarseness in 3 patients. *ACCF: dura laceration in 1, incomplete transient C5 palsy in 1 patient.

RESULTSClinical Outcomes ACDF ACCF p

Preop neck VAS 5.6 5.4 >0.05

Postop neck VAS 2.8 2.5 >0.05

Preop arm VAS 6.2 5.9 >0.05

Postop arm VAS 2.7 2.6 >0.05

Radiological parameters

ACDF ACCF p

Fusion rate (%) 100 100 >0.05

Preop cervical lordosis (degrees)

18.3 17.4 >0.05

Postop cervical lordosis (degrees)

24.4 21.6 0.045

MT, 47 y, M

MT, 49 y, M

CONCLUSION

Surgical management of 2-level cervical degenerative

disc disease with myeloradiculopathy by ACDF or ACCF

showed no significant differences in terms of clinical

symptom improvement and fusion rates.

CONCLUSION

Although statistically insignificant, blood loss and

operation times were lower in ACDF group.

In addition, ACCF provided less improvement in cervical

lordosis.

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