Reoperation rates and patient-reported outcomes of single and two-level anterior cervical discectomy and fusion.

Abstract

The purposes of this study were to identify the 2year rate of reoperation and determine patient-reported outcomes after elective one- and two-level anterior cervical discectomy and fusion (ACDF) with structural allograft and anterior plating using indications similar to cervical disc arthroplasty. A retrospective chart review was performed on 116 consecutive one- and two-level primary ACDF for adult degenerative disease with structural allograft and anterior plating in one surgeon's practice. Patient-reported visual analog score (VAS), Oswestry disability index (ODI) and radiographs, collected prospectively on all operative patients preoperatively and postoperatively at 6weeks, 3months, 6months, 1year, and 2years were reviewed. Patient demographics and reoperation rates were obtained from the chart. One hundred and four patients were identified with a final reoperation rate of 2.9% at a mean final follow-up 2years (95% CI 17.2-29.0). No reoperations occurred within 90days. After 1year, three patients required reoperation. The mean patient-reported outcomes improved (VAS, 6.6 preoperatively to 3.0 at final follow-up and ODI, 24.3 preoperatively to 12.3 at final follow-up). These improvements were statistically significant (p < 0.01). No significant patient risk factors for reoperation were found. The rate of reoperation for one- and two-level anterior cervical discectomy and fusion at follow-up was found to be lower than those previously published in the literature quoted for CDA. Arthrodesis continues to demonstrate improvements in patient-reported outcomes.