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Treatment of the two-level degenerative cervical disk diseases based on algorithmic anterior approach: a multicenter prospective study

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Abstract

To analyze the effectiveness of an algorithmic anterior approach to the surgical treatment of patients with two-level cervical degenerative disk disease based on the preoperative clinical and imaging parameters. The study included 244 patients with two-level cervical degenerative disk disease. Three groups of patients were evaluated at 3 neurosurgical centers between 2016–2019. The prospective group (Group I, n = 126) consisted of patients who were treated using an algorithm to decide whether they should be treated with a two-level Total Disk replacement (TDR), Anterior Cervical Discectomy and Fusion (ACDF) and hybrid technique. The control group (Group II, n = 118) consisted of patients who underwent two-level anterior decompression with TDR, ACDF and hybrid stabilization between 2005–2015. Visual Analogue Scale (VAS) neck pain, VAS upper limbs pain, Neck Disability Index (NDI), SF-36, Macnab and Nurick scales were collected. Perioperative complications were identified. At 2 years of follow up Group I had significantly better clinical outcomes based on VAS neck pain score (p = 0.02), VAS upper limbs pain (p = 0.04), NDI score (p = 0.02), SF-36 score (p = 0.01), satisfaction with surgery on the Macnab scale (p < 0.001) and outcome of surgery based on Nurick scale (p < 0.001). Complication rate was lower in Group I, 6.3% compared to 24.6% in Group II, p = 0.0001. The algorithmic anterior approach to the surgical treatment of patients with two-level cervical degenerative disk disease resulted in significant improvement of functional outcomes and a decrease in complications at a minimum 2 years of follow-up.

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Data availability

Data are available from the corresponding author (prof. Vadim A. Byvaltsev) for researchers who meet the criteria for access to confidential data.

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Authors and Affiliations

  1. Department of Neurosurgery, Irkutsk State Medical University, 1 Krassnogo Vosstaniya Street, off 201, 664003, Irkutsk, Irkutskaya Oblast’, Russia

    Vadim A. Byvaltsev, Andrei A. Kalinin, Marat A. Aliyev, Bakhyt M. Aglakov & Alexander V. Kuharev

  2. Department of Neurosurgery, Railway Clinical Hospital, Irkutsk, Russia

    Vadim A. Byvaltsev & Andrei A. Kalinin

  3. Department of Traumatology, Orthopedic and Neurosurgery, Irkutsk State Medical Academy of Postgraduate Education, Irkutsk, Russia

    Vadim A. Byvaltsev

  4. Department of Neurosurgery, Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan

    Marat A. Aliyev & Bakhyt M. Aglakov

  5. Department of Neurosurgery, Federal Siberian Scientific and Clinical Center of the Federal Medical and Biological Agency, Krasnoyarsk, Russia

    Alexander V. Kuharev

  6. Kazakhstan Medical University “Higher School of Public Health”, Almaty, Kazakhstan

    Nurzhan O. Azhibekov

Authors
  1. Vadim A. Byvaltsev
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  3. Marat A. Aliyev
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  4. Bakhyt M. Aglakov
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  5. Alexander V. Kuharev
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  6. Nurzhan O. Azhibekov
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Contributions

Each author made significant individual contributions to this manuscript. VAB (0000-0003-4349-7101)*, AAK (0000-0002-6059-4344)* and MAA (0000-0002-3190-2395)* were the main contributors to the drafting of the manuscript. VAB, AAK, MAA, BMA (0000-0001-5458-0184), AVK (0000-0001-7709-5800) and NOA (0000-0002-4902-3874) performed the surgery, and patient follow-up, and gathered clinical data. AAK, MAA, AVK evaluated the data from the statistical analysis. VAB, AAK, MAA and BMA performed the literature search and review of the manuscript, and contributed to the intellectual concept of the study. *ORCID (Open Researcher and Contributor ID).

Corresponding author

Correspondence to Vadim A. Byvaltsev.

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Ethical approval

The study was approved by the Ethics Committee of Irkutsk State Medical University, protocol № 3, dated November 15, 2016.

Competing interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

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Byvaltsev, V.A., Kalinin, A.A., Aliyev, M.A. et al. Treatment of the two-level degenerative cervical disk diseases based on algorithmic anterior approach: a multicenter prospective study. Neurosurg Rev 46, 247 (2023). https://doi.org/10.1007/s10143-023-02157-3

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  • DOI: https://doi.org/10.1007/s10143-023-02157-3

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