Abstract
Anterior cervical plating is commonly performed to stabilize anterior cervical fusion. The aim of the study was to evaluate the clinical and functional outcome, radiological fusion and operative complications in cases of cervical spondylotic myelopathy and radiculopathy who underwent Anterior Cervical Discectomy and Fusion (ACDF) by autograft and stabilized with plate and screw. We evaluated 16 consecutive patients (M: F = 10:6) from January 2008 to December 2010 in Bangabandhu Sheikh Mujib Medical University (BSMMU) and different private hospitals in Dhaka, in cases where adequate conservative treatment failed. Single level ACDF by autograft and stabilization by plate and screw was done in 10 patients and 06 patients had two levels fusion. The mean follow up period was 18 months. The patients improved significantly (p < 0.05) and the recovery rate was 87.50%. All patients showed radiological fusion (p < 0.001). There was no hardware failure, graft extrusion or plate breakage. ACDF with plate and screw is fairly safe and effective therapy for cervical disc degeneration leading to myelo-radiculopathy where major post operative complications are uncommon.
Highlights
Cervical spondylotic myelo-radiculopathy (CSMR) is a spinal cord dysfunction (SCD) accompanying typical age related degeneration of the cervical spine[1]
We focused on operating room time, hospital stay, intra and postoperative complications, outcome and time to return to normal activities including work
Almost all patients worsen if left untreated and most studies report significant numbers of patients progressing to severe disability[12]
Summary
Cervical spondylotic myelo-radiculopathy (CSMR) is a spinal cord dysfunction (SCD) accompanying typical age related degeneration of the cervical spine[1]. Myelopathic or upper motor neuron lesion (UMNL) findings (e.g. hyperreflexia and gait disturbance) are the typical manifestations and the most common cause of SCD after 55 years[2]. Instability by altered biomechanics of the cervical spinal column invites inflammatory reparative process which produces arthritic pain and facet hypertrophy leading to spur formation[2]. Neck or shoulder pain with radiation to one or both upper limbs, tingling, numbness or weakness in the hand is common presenting symptoms of cervical radiculopathy. Features of myelopathy include, altered gait, muscle weakness, bladder/ bowel dysfunction, reduced fine motor skills, which all depends upon the location of compression
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