Functional outcome of Anterior Cervical Discectomy and Fusion with Anterior Cervical Plating Among Patients of Cervical Disc Disease at a Tertiary Health Care Centre

Abstract

Introduction: Cervical spondylosis means osteoarthritis of cervical spinal column. The degenerative process mainly affects the vertebrae, neural foramina and the facet joints. It leads to compression of the spinal cord resulting in progressive neural cell loss and neurological deterioration in 40 to 60 % of patients. Cervical myelopathy is a constellation of symptoms and physical findings including motor and sensory abnormalities. Spasticity and paresis are frequently seen. The patient often complaints of gait disturbance due to abnormalities incorticospinal tract and spinal spinocerebellar tracts. There is also associated loss of grip strength and finger movements. Anterior cervical discectomy and fusion (ACDF) is a commonly performed procedure to remove a herniated or degenerative disc. An incision is made in the anterior cervical region and the disc is then removed. A graft is then placed to fuse the vertebrae above and below the disc. ACDF was first described by Cloward, Smith and Robinson in 1958 and shortly later by Hirsch in 1960 who described anterior cervical decompression and debated the necessity for inter body fusion. Anterior cervical discectomy and fusion has been widely performed since the late 1950s and is currently recommended in patients in whom the nonoperative modalities for single level or multilevel disease have failed. Objectives: To study the functional outcome of cervical discectomy and fusion with anterior cervical plating among patients of cervical disc disease. Materials and Methods: 46 patients treated with ACDF with anterior cervical plating were considered in this study. Results and Conclusion: All the patients showed significant post-operative improvement in their symptoms and diagnostic scores. Thus, we can conclude that ACDF with anterior cervical plating is an efficient procedure in patients with cervical myelopathic symptoms not responding to conservative treatment.