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Anterior cervical discectomy fusion

Ahilan Sivaganesan, Brandon Hirsch, Frank M Phillips, Matthew J McGirt
Here, we systematically review clinical studies that report morbidity and outcomes data for cervical and lumbar surgeries performed in ambulatory surgery centers (ASCs). We focus on anterior cervical discectomy and fusion (ACDF), posterior cervical foraminotomy, cervical arthroplasty, lumbar microdiscectomy, lumbar laminectomy, and minimally invasive transforaminal interbody fusion (TLIF) and lateral lumbar interbody fusion, as these are prevalent and surgical spine procedures that are becoming more commonly performed in ASC settings...
March 12, 2018: Neurosurgery
Jia-Fu Zhu, Ning Yan, Wei-Xing Xu, Tie-Sheng Hou, Shun-Zhi Yu, Hong Liu, Li-Feng Zhai
OBJECTIVE: To compare the clinical effects between anterior cervical discectomy and fusion(ACDF) combined with anterior cervical corpectomy and fusion(ACCF) and cervical posterior single open-door laminoplasty with mini-titanium plate fixation in treating three-segment cervical spondylotic myelopathy. METHODS: The clinical data of 63 patients (39 males and 24 females) with three-segment cervical spondylotic myelopathy underwent surgical treatment from March 2014 to March 2016 were retrospectively analyzed...
January 25, 2018: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Jared D Ament, Tejas Karnati, Edwin Kulubya, Kee D Kim, J Patrick Johnson
Background: The surgical treatment of cervical radiculopathy has centered around anterior cervical discectomy and fusion (ACDF). Alternatively, the posterior cervical laminoforaminotomy/microdiscectomy (PCF/PCM), which results in comparable outcomes and is more cost-effective, has been underutilized. Methods: Here, we compared the direct/indirect costs, reoperation rates, and outcome for ACDF and PCF vs. PCM using PubMed, Medline, and Embase databases. Results: There were no significant differences between the re-operative rates of PCF/PCM (2% to 9...
2018: Surgical Neurology International
Guang-Zhi Ning, Shun-Li Kan, Ru-Sen Zhu, Shi-Qing Feng
OBJECTIVE: Mobi-C cervical disc arthroplasty (MCDA) has been regarded as an alternative to anterior cervical discectomy and fusion (ACDF). In this study, the effectiveness and safety between MCDA and ACDF for symptomatic cervical degenerative disc disease was evaluated. METHODS: PubMed, EMBASE, and the Cochrane Library were systematically searched for randomized controlled trials. Studies were included based on the eligibility criteria. Risk of bias assessment and quality of evidence assessment were performed...
March 7, 2018: World Neurosurgery
Bjørn E Juel, Luis Romundstad, Frode Kolstad, Johan F Storm, Pål G Larsson
Objective: The objective of this study was to test whether properties of 1-s segments of spontaneous scalp EEG activity can be used to automatically distinguish the awake state from the anesthetized state in patients undergoing general propofol anesthesia. Methods: Twenty five channel EEG was recorded from 10 patients undergoing general intravenous propofol anesthesia with remifentanil during anterior cervical discectomy and fusion. From this, we extracted properties of the EEG by applying the Directed Transfer Function (DTF) directly to every 1-s segment of the raw EEG signal...
2018: Frontiers in Human Neuroscience
Chun-Kun Park, Kyeong-Sik Ryu
Since the launch of cervical total disc replacement (CTDR) in the early 2000s, many clinical studies have reported better outcomes of CTDR compared to those of anterior cervical discectomy and fusion. However, CTDR is still a new and innovative procedure with limited indications for clinical application in spinal surgery, particularly, for young patients presenting with soft disc herniation with radiculopathy and/or myelopathy. In addition, some controversial issues related to the assessment of clinical outcomes of CTDR remain unresolved...
February 2018: Asian Spine Journal
Germain Forestier, Laurent Riffaud, François Petitjean, Pierre-Louis Henaux, Pierre Jannin
PURPOSE: Surgery is one of the riskiest and most important medical acts that are performed today. The need to improve patient outcomes and surgeon training, and to reduce the costs of surgery, has motivated the equipment of operating rooms with sensors that record surgical interventions. The richness and complexity of the data that are collected call for new methods to support computer-assisted surgery. The aim of this paper is to support the monitoring of junior surgeons learning their surgical skill sets...
March 3, 2018: International Journal of Computer Assisted Radiology and Surgery
Man-Kyu Park, Dae-Chul Cho, Woo-Seok Bang, Kyoung-Tae Kim, Joo-Kyung Sung
PURPOSE: Delayed esophageal perforation after anterior cervical discectomy and fusion (ACDF) is an extremely rare cause of infection such as spondylodiscitis. We present a rare case in which a patient had two delayed esophageal perforations occurring 20 and 25 years after ACDF. By sharing our experience of this rare case, we hope to provide new information related to delayed esophageal perforation. METHODS: We present the case of a 72-year-old patient who underwent ACDF due to cervical spondylosis 25 years ago...
March 2, 2018: European Spine Journal
Dong-Ho Lee, Jae Hwan Cho, Choon Sung Lee, Chang Ju Hwang, Sung Hoon Choi, Chul Gie Hong
BACKGROUND CONTEXT: Conventional anterior decompression surgery for cervical myelopathy, including anterior corpectomy and fusion, is technically demanding and known to be associated with a higher incidence of surgery-related complications, including cerebrospinal fluid (CSF) leakage, neurologic deterioration, and graft failure compared with posterior surgery. PURPOSE: We introduce a novel anterior decompression technique (vertebral body sliding osteotomy; VBSO) for cervical myelopathy caused by ossification of posterior longitudinal ligament (OPLL) and evaluate the efficacy and safety of this procedure...
February 26, 2018: Spine Journal: Official Journal of the North American Spine Society
David Z Cai, Ryan P Roach, John P Weaver, Gerald T McGillicuddy, Zachary M Mansell, Jonathan P Eskander, Mark S Eskander
This is a case report of a 48-year-old man with multiple transient ischemic attacks and a known hypoplastic right vertebral artery (VA) who presented after a syncopal event while turning his head to the left. The objective of this study is to demonstrate the necessity of proper diagnosis and management of cerebrovascular pathology including imaging and surgical intervention in patients with known anatomical anomalies. This study was conducted at Massachusetts, United States of America. Our patient's history was significant for a hypoplastic right VA and a stenotic segment of the right VA at the C3-C4 junction...
January 2018: Asian Journal of Neurosurgery
Ammar H Hawasli, John L Cashin, Neill M Wright
BACKGROUND: Adjacent-level disease after anterior cervical discectomy and fusion (ACDF) occurs in a significant proportion of patients and frequently requires revision operation. Methods using traditional plates typically require removal of the plate with anecdotally increased operative-time and morbidity. We review our experience in treating symptomatic adjacent-segment disease using both traditional plate removal and modular- plate system which allows for add-on plate components rather than removal of the entire plate...
February 23, 2018: Journal of Neurosurgical Sciences
Ehab Shiban, Moritz Nies, Johann Kogler, Lorenz Kogler, Pedro Ribeiro da Cunha, Bernhard Meyer, Jens Lehmberg
AIM: To correlate clinical and radiological outcome following one- and two-level anterior cervical discectomy and fusion (ACDF) with stand-alone polyetheretherketone (PEEK) cages filled with demineralized bone matrix (DBM). METHODS: We performed a retrospective review of a consecutive patient cohort with degenerative disc disease that underwent ACDF with stand-alone PEEK cages filled with demineralized bone matrix (DBM) between 2010 and 2013 with a minimum follow-up of 12 months...
February 26, 2018: Acta Neurochirurgica
Yijian Zhang, Hao Liu, Huilin Yang, Bin Pi
PURPOSE: To compare the postoperative sagittal balance and occurrence of axial symptoms between anterior cervical corpectomy and fusion (ACCF) and anterior cervical discectomy and fusion (ACDF) for the treatment of two-level cervical spondylotic myelopathy (CSM). METHODS: A total of 71 consecutive patients who underwent ACCF or ACDF for two-level CSM in our institution from January 2014 to December 2016 were retrospectively reviewed. Of these patients, 30 (17 males, 13 females) were subjected to ACCF, and 41 (20 males, 21 females) were treated with ACDF...
February 24, 2018: International Orthopaedics
Se-Il Jeon, Seung-Jae Hyun, Sanghyun Han, Byoung Hun Lee, Ki-Jeong Kim, Tae-Ahn Jahng, Hyun-Jib Kim
BACKGROUND: T1 slope minus C2-C7 lordosis (TS-CL) and cervical sagittal alignment reportedly affect health-related quality-of-life (HRQOL) scores following multilevel posterior cervical fusion surgery. There are no reports of a relationship between cervical alignment and patient outcomes after anterior cervical discectomy and fusion (ACDF) involving three or more levels. This study aimed to investigate the relationship between cervical sagittal alignment and patient-reported HRQOL after three-or-more-level ACDF...
February 21, 2018: World Neurosurgery
Cody J Mansfield
INTRODUCTION: The patient was referred to an outpatient physical therapy clinic for lumbar radiculopathy by a primary care physician and subsequently referred for imaging due to suspicion of cervical myelopathy. The case highlights the clinical reasoning of the physical therapist differentiating between lumbar stenosis, cervical myelopathy, and upper cervical instability. To the author's knowledge, this is the only case report in the literature to describe the mechanism that could underpin a false positive Sharp-Purser test (SPT)...
February 23, 2018: Physiotherapy Theory and Practice
Iris Noordhoek, Marvyn T Koning, Wilco C H Jacobs, Carmen L A Vleggeert-Lankamp
BACKGROUND: The placement of intervertebral cages in anterior cervical discectomy (ACDF) supposedly maintains foraminal height. The most commonly reported cage-related complication is subsidence, although it is unknown whether a correlation between subsidence and clinical outcome exists. AIM: To assess the incidence and relevance of subsidence. METHODS: Literature searches were performed in PubMed, MEDLINE, Embase, Web of Science, COCHRANE, and CENTRAL...
February 21, 2018: Acta Neurochirurgica
Joseph L Laratta, Jamal N Shillingford, Comron Saifi, K Daniel Riew
Study Design: Systematic review. Objectives: Degenerative disc disease and spondylosis resulting in radiculopathy and retrodiscal myelopathy are among the most frequently encountered cervical spinal disorders. Traditionally, anterior cervical discectomy and fusion (ACDF) has successfully achieved neural decompression and restored intradiscal height in these conditions. Unfortunately, nonunion and iatrogenic adjacent segment pathology associated with fusion procedures in the cervical spine has led to an interest in motion-preserving procedures...
February 2018: Global Spine Journal
Samuel C Overley, Robert K Merrill, Evan O Baird, Joshua J Meaike, Samuel K Cho, Andrew C Hecht, Sheeraz A Qureshi
Study Design: Prospective randomized control trial. Objective: To investigate the role of cervical collars in postoperative care following 1- and 2-level instrumented anterior cervical discectomy and fusion (ACDF). Methods: The Cervical Spine Research Society Resident Fellow Grant funded this project. Fifty consecutive patients undergoing 1- or 2-level ACDF surgery were randomized into groups receiving either no brace or a cervical brace for 6 weeks postoperatively...
February 2018: Global Spine Journal
Steven J McAnany, Robert K Merrill, Samuel C Overley, Jun S Kim, Robert L Brochin, Sheeraz A Qureshi
Study Design: Cost-effectiveness analysis. Objectives: To determine the 7-year cost-effectiveness of cervical disc replacement (CDR) and anterior cervical discectomy and fusion (ACDF). Methods: We analyzed 7-year Short Form-36 Health Survey data collected from the Prestige Cervical Disc investigational device exemption study (IDE). The SF-6D algorithm was used to convert this data into health state utilities. Costs were calculated from the payer perspective, and quality adjusted life years (QALYs) were used to represent effectiveness...
February 2018: Global Spine Journal
Steven J McAnany, Robert K Merrill, Robert L Brochin, Samuel C Overley, Jun S Kim, Sheeraz A Qureshi
Study Design: Health utility analysis. Objectives: To determine the health state utility (HSU) of 1- and 2-level anterior cervical discectomy and fusion (ACDF) and cervical disc replacement (CDR). Methods: Data from the Medtronic Prestige Cervical Disc investigational device exemption studies was used. Four groups were defined: 1-level ACDF, 1-level CDR, 2-level ACDF, and 2-level CDR. The 36-item Short Form Health Survey (SF-36) was collected at baseline, 12 months, 24 months, 36 months, and 60 months postoperatively and converted into utility scores for each time point...
February 2018: Global Spine Journal
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