Abstract
BackgroundCervical degenerative pathology produces pain and disability, and if conservative treatment fails, surgery is indicated. The aim of this study was to determined whether anterior decompression and interbody fusion according to Cloward is effective for treating segmental cervical degenerative pathology and whether the results are durable after a 10-year-minimum follow-up.Materials and methodsFifty-one patients affected by single-level cervical degenerative pathology between C4 and C7 were surgically treated by the Cloward procedure. Clinical evaluation was rated using the Neck Disability Index (NDI) and the visual analog scale (VAS). At last follow-up, the outcomes were rated according to Odom’s criteria. On radiographs, the sagittal segmental alignment (SSA) of the affected level and the sagittal alignment of the cervical spine (SACS) were measured.ResultsAverage NDI was 34 preoperatively and 11 at last follow-up. Average VAS was 7 preoperatively and 1 at last follow-up. According to Odom’s criteria, the outcome was considered excellent in 18 cases, good in 22, and fair in 11. Average SSA was 0.5 ± 2.1 preoperatively, 1.8 ± 3.8 at 6 months, and 1.8 ± 5.7 at last follow-up. Average SACS was 16.5 ± 4.0 preoperatively, 20.9 ± 5.8 at 6 months, and 19.9 ± 6.4 at last follow-up. Degenerative changes at the adjacent levels were observed in 18 patients (35.3%).ConclusionsThe Cloward procedure proved to be a suitable and effective technique for treating segmental cervical degenerative pathology, allowing good clinical and radiographic outcomes even at a long-term follow-up.
Highlights
Cervical disc herniation and cervical spondylosis are common causes of acquired disability in patients over 50 years [1]
The aim of this study was to determined whether anterior decompression and interbody fusion according to Cloward is effective for treating segmental cervical degenerative pathology and whether the results are durable after a 10-year-minimum follow-up
When conservative treatment for cervical disc herniation and cervical spondylosis fails, surgical treatment is indicated, and anterior decompression and fusion are considered as the treatment of choice [11, 13, 14, 17, 30,31,32]
Summary
Cervical disc herniation and cervical spondylosis are common causes of acquired disability in patients over 50 years [1]. These two clinical pathologies can lead to different conditions ranging from axial neck pain to cervical radiculopathy and cervical myelopathy. Cervical degenerative pathology produces pain and disability, and if conservative treatment fails, surgery is indicated. The aim of this study was to determined whether anterior decompression and interbody fusion according to Cloward is effective for treating segmental cervical degenerative pathology and whether the results are durable after a 10-year-minimum follow-up. Materials and methods Fifty-one patients affected by single-level cervical degenerative pathology between C4 and C7 were surgically treated by the Cloward procedure. The sagittal segmental alignment (SSA) of the affected level and the sagittal alignment of the cervical spine (SACS) were measured
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