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Clinical outcome following anterior cervical discectomy and fusion with and without anterior cervical plating for the treatment of cervical disc herniation—a 25-year follow-up study

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Abstract

Extreme long-term clinical outcome studies following anterior cervical discectomy and fusion (ACDF) with an autologous iliac crest with and without Caspar plating (ACDF + CP) for the treatment of radiculopathy caused by cervical disc herniation (CDH) are extremely rare. Hospital records of patients who underwent ACDF or ACDF + CP for the treatment of CDH at least 17 years ago were reviewed. Information about diagnosis, surgery, pre- and postoperative clinical process, and repeated procedure was analyzed. At final follow-up, patients were reviewed with a standardized questionnaire including the current neurological status, Neck Disability Index (NDI), Odom’s criteria, a modified EQ-5D, and limitations in quality of life. One hundred twenty-two patients with a mean follow-up of 25 years were evaluated. ACDF was performed in 80 and ACDF + CP in 42 patients, respectively. At final follow-up, 81.1% of patients were free of radicular pain and had no repeated procedure. According to Odom’s criteria, 86.1% of good to excellent functional recovery was noted. The mean NDI and EQ-5D was 14% and 5 points, respectively. There was no significant difference in the assessed clinical outcome parameters between patients treated with ACDF and ACDF + CP. The rate for repeated procedure due to degenerative cervical disorders was 10.7 and 7.4% due to symptomatic adjacent segment disease with 25 years. ACDF and ACDF + CP achieved a high rate radicular pain relief (89.3%) and clinical success (86.1%) for the treatment of CDH within a 25 years follow-up. No statistical difference concerning clinical outcome and rate of repeated procedure was detected.

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Acknowledgements

The authors thank Gudrun Wagenpfeil at the Institution of Medical Informatics, Biometry and Epidemiology (IMBEI), Saarland University Faculty of Medicine, for her contribution to this study.

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Authors and Affiliations

  1. Department of Neurosurgery, Saarland University Medical Center and Saarland University Faculty of Medicine, Homburg, Saar, Germany

    Benedikt W. Burkhardt, Moritz Brielmaier, Karsten Schwerdtfeger & Joachim M. Oertel

  2. Klinik für Neurochirurgie, Universitätsklinikum des Saarlandes und Medizinische Fakultät der Universität des Saarlandes, Kirrbergerstraße 100, Gebäude 90.5, 66421, Homburg, Germany

    Benedikt W. Burkhardt

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  1. Benedikt W. Burkhardt
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Correspondence to Benedikt W. Burkhardt.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Burkhardt, B.W., Brielmaier, M., Schwerdtfeger, K. et al. Clinical outcome following anterior cervical discectomy and fusion with and without anterior cervical plating for the treatment of cervical disc herniation—a 25-year follow-up study. Neurosurg Rev 41, 473–482 (2018). https://doi.org/10.1007/s10143-017-0872-6

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  • DOI: https://doi.org/10.1007/s10143-017-0872-6

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