Favourable long-term clinical outcome after anterior cervical discectomy. A study on a series of 125 patients undergoing surgery a mean of 11 years earlier.
OBJECTIVE
This retrospective study assessed long-term clinical outcome in a series of patients undergoing anterior cervical discectomy (ACD) for treatment of myeloradiculopathy secondary to one- to two-level cervical discoarthrosis. To verify concerns about long-term adverse clinical effects following ACD, a review of literature on the topic was also made.


METHODS
The clinical course and long-term outcome of 125 consecutive patients with cervical myeloradiculopathy operated on by ACD 5 to 19 years ago (mean, 11.3 years) were reviewed. Seventy-four patients (59%) showed a clinical picture of pure radiculopathy, and 51 patients (41%) had myeloradiculopathy. Long-term clinical outcome and Visual Analog Scale (VAS) scores for neck and arm pain were recently assessed and compared with post-surgical status. Clinical outcome was graded according to the criteria of Odom et al. (JAMA 166:23-28, 36). The survey of the literature on long-term clinical outcome after ACD was internet-based.


RESULTS
Long-term clinical outcome was excellent in 61% of patients, good in 26%, satisfactory in 9% and poor in 4%. The same figures at the time of discharge were 65%, 29%, 6% and 0%, respectively. Mean long-term neck and arm pain VAS scores were 2.5 and 0.8, respectively, while postoperatively, the same values were 2.1 and 0.5. Additional discectomy at an adjacent level was performed in five patients 10 months to 8 years after the first operation.


CONCLUSIONS
In our series, 96% of patients had a sustained favourable long-term clinical outcome after ACD. These favourable results confirm data in the literature and support our preference for ACD as the simplest, fastest and cheapest surgical option for treating myeloradiculopathy secondary to one- to two-level cervical discoarthrosis.
Palma
Lucio
L
Department of Neurological, Neurosurgical and Behavioural Sciences, Siena University Medical School, Siena, Italy. palma@unisi.it
Mariottini
Aldo
A
Carangelo
Biagio
B
Muzii
Vitaliano Francesco
VF
Zalaffi
Alessandro
A
D017586:Diskectomy / Q000379:methods* / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D008297:Male; D017063:Outcome Assessment, Health Care / Q000379:methods*; D011843:Radiculopathy / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D011859:Radiography; D012189:Retrospective Studies; D055009:Spondylosis / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome