Evaluation of arthrodesis and cervical alignment in the surgical results of cervical discectomy using polymethylmetacrylate.
OBJECTIVE
Surgical treatment of cervical radiculopathy with or without myelopathy is a controversy issue, although anterior discectomy is the most common form of treatment.


METHODS
We present the evaluation of the arthrodesis' rate and cervical alignment in 48 patients with cervical degenerative disease (CDD) submitted to anterior cervical discectomy with interposition of polymethylmetacrylate (PMMA). Odom and Nürick scales were used to evaluation of functional status before and after surgery. Cervical spine X-rays were used to access arthrodesis and alignment, at least 2 years after the procedure.


RESULTS
Excellent and good results (Odom I and II) were obtained in 91% of the patients with radiculopathy and in 69% of those with myelopathy. Using the chi square test of independence (1% of significance), there was no association between excellent and good clinical results with the presence of arthrodesis verified in cervical X-rays. The presence of cervical alignment had association with good results, whereas the misalignment was associated with unfavorable outcomes. Two patients died: one cervical hematoma and other from graft migration with cord compression.


CONCLUSIONS
Cervical alignment was more important than fusion to achieve good surgical results in CDD.
Department of Neurology and Neurosurgery, Federal University of São Paulo, São Paulo, SP, Brazil. mlmudo@uol.com.br
Marcelo Luis
ML
Mudo
Andrea Vieira
AV
Amantea
Andrei Fernandes
AF
Joaquim
Mirto Nelso
MN
Prandini
Sérgio
S
Cavalheiro
D000328:Adult; D000368:Aged; D001174:Arthrodesis; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery*; D017586:Diskectomy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D019904:Polymethyl Methacrylate; D011843:Radiculopathy / Q000000981:diagnostic imaging / Q000601:surgery*; D011859:Radiography; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013118:Spinal Cord Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult
D019904:Polymethyl Methacrylate