Safety and efficacy of day anterior cervical discectomy and fusion procedure for degenerative cervical spondylosis: a retrospective analysis

Abstract Objective Our study aimed to develop a day anterior cervical discectomy and fusion (ACDF) procedure to treat degenerative cervical spondylosis (DCS). The goal was to analyze its clinical implications, safety, and early effects to provide a better surgical option for eligible DCS patients. M...

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Main Authors: Long Tang, Yu Chen, Fandong Wang, Yuanbin Liu, Zhaojun Song, Miao Wang, Yong Zhou, Huiyi Liu, Jiazhuang Zheng
Format: Article
Language:English
Published: BMC 2024-03-01
Series:BMC Musculoskeletal Disorders
Subjects:
Online Access:https://doi.org/10.1186/s12891-024-07356-7
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author Long Tang
Yu Chen
Fandong Wang
Yuanbin Liu
Zhaojun Song
Miao Wang
Yong Zhou
Huiyi Liu
Jiazhuang Zheng
author_facet Long Tang
Yu Chen
Fandong Wang
Yuanbin Liu
Zhaojun Song
Miao Wang
Yong Zhou
Huiyi Liu
Jiazhuang Zheng
author_sort Long Tang
collection DOAJ
description Abstract Objective Our study aimed to develop a day anterior cervical discectomy and fusion (ACDF) procedure to treat degenerative cervical spondylosis (DCS). The goal was to analyze its clinical implications, safety, and early effects to provide a better surgical option for eligible DCS patients. Methods A retrospective analysis was performed to identify DCS patients who underwent day ACDF from September 2022 to August 2023. The operative time, intraoperative blood loss, postoperative drainage, preoperative and postoperative visual analog scale (VAS) scores, neck disability index (NDI) scores, Japanese Orthopedic Association (JOA) scores, JOA recovery rate (RR), incidence of dysphagia-related symptoms, 30-day hospital readmission rate, and incidence of other complications were recorded to evaluate early clinical outcomes. Radiography was performed to assess the location of the implants, neurological decompression, and cervical physiological curvature. Results All 33 patients (23 women and 10 men) underwent successful surgery and experienced significant symptomatic and neurological improvements. Among them, 26 patients underwent one-segment ACDF, 5 underwent two-segment ACDF, and 2 underwent three-segment ACDF. The average operative time was 71.1 ± 20.2 min, intraoperative blood loss was 19.1 ± 6.2 mL, and postoperative drainage was 9.6 ± 5.8 mL. The preoperative VAS and NDI scores improved postoperatively (7.1 ± 1.2 vs. 3.1 ± 1.3 and 66.7% ± 4.8% vs. 24.1% ± 2.5%, respectively), with a significant difference (P < 0.01). Moreover, the preoperative JOA scores improved significantly postoperatively (7.7 ± 1.3 vs. 14.2 ± 1.4; P < 0.01) with an RR of 93.9% in good or excellent. Postoperative dysphagia-related symptoms occurred in one patient (3.0%). During the follow-up period, no patient was readmitted within 30 days after discharge; however, an incisional hematoma was reported in one patient on the 6th day after discharge, which was cured by pressure dressing. The postoperative radiographs revealed perfect implant positions and sufficient nerve decompression in all patients. Furthermore, the preoperative cervical physiological curvature improved significantly after the operation (14.5° ± 4.0° vs. 26.3° ± 5.4°; P < 0.01). Conclusions Day ACDF has good safety and early clinical efficacy, and it could be an appropriate choice for eligible DCS patients.
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spelling doaj.art-56abf28326c2494ea00964b95e0d343d2024-03-24T12:08:14ZengBMCBMC Musculoskeletal Disorders1471-24742024-03-012511810.1186/s12891-024-07356-7Safety and efficacy of day anterior cervical discectomy and fusion procedure for degenerative cervical spondylosis: a retrospective analysisLong Tang0Yu Chen1Fandong Wang2Yuanbin Liu3Zhaojun Song4Miao Wang5Yong Zhou6Huiyi Liu7Jiazhuang Zheng8Department of Spine Surgery, Suining Central HospitalDepartment of Spine Surgery, Suining Central HospitalDepartment of Spine Surgery, Suining Central HospitalDepartment of Spine Surgery, Suining Central HospitalDepartment of Spine Surgery, Suining Central HospitalDepartment of Spine Surgery, Suining Central HospitalDepartment of Spine Surgery, Suining Central HospitalDepartment of Spine Surgery, Suining Central HospitalDepartment of Spine Surgery, Suining Central HospitalAbstract Objective Our study aimed to develop a day anterior cervical discectomy and fusion (ACDF) procedure to treat degenerative cervical spondylosis (DCS). The goal was to analyze its clinical implications, safety, and early effects to provide a better surgical option for eligible DCS patients. Methods A retrospective analysis was performed to identify DCS patients who underwent day ACDF from September 2022 to August 2023. The operative time, intraoperative blood loss, postoperative drainage, preoperative and postoperative visual analog scale (VAS) scores, neck disability index (NDI) scores, Japanese Orthopedic Association (JOA) scores, JOA recovery rate (RR), incidence of dysphagia-related symptoms, 30-day hospital readmission rate, and incidence of other complications were recorded to evaluate early clinical outcomes. Radiography was performed to assess the location of the implants, neurological decompression, and cervical physiological curvature. Results All 33 patients (23 women and 10 men) underwent successful surgery and experienced significant symptomatic and neurological improvements. Among them, 26 patients underwent one-segment ACDF, 5 underwent two-segment ACDF, and 2 underwent three-segment ACDF. The average operative time was 71.1 ± 20.2 min, intraoperative blood loss was 19.1 ± 6.2 mL, and postoperative drainage was 9.6 ± 5.8 mL. The preoperative VAS and NDI scores improved postoperatively (7.1 ± 1.2 vs. 3.1 ± 1.3 and 66.7% ± 4.8% vs. 24.1% ± 2.5%, respectively), with a significant difference (P < 0.01). Moreover, the preoperative JOA scores improved significantly postoperatively (7.7 ± 1.3 vs. 14.2 ± 1.4; P < 0.01) with an RR of 93.9% in good or excellent. Postoperative dysphagia-related symptoms occurred in one patient (3.0%). During the follow-up period, no patient was readmitted within 30 days after discharge; however, an incisional hematoma was reported in one patient on the 6th day after discharge, which was cured by pressure dressing. The postoperative radiographs revealed perfect implant positions and sufficient nerve decompression in all patients. Furthermore, the preoperative cervical physiological curvature improved significantly after the operation (14.5° ± 4.0° vs. 26.3° ± 5.4°; P < 0.01). Conclusions Day ACDF has good safety and early clinical efficacy, and it could be an appropriate choice for eligible DCS patients.https://doi.org/10.1186/s12891-024-07356-7Cervical spondylosisDiskectomySpinal fusionDay surgeryClinical efficacy
spellingShingle Long Tang
Yu Chen
Fandong Wang
Yuanbin Liu
Zhaojun Song
Miao Wang
Yong Zhou
Huiyi Liu
Jiazhuang Zheng
Safety and efficacy of day anterior cervical discectomy and fusion procedure for degenerative cervical spondylosis: a retrospective analysis
BMC Musculoskeletal Disorders
Cervical spondylosis
Diskectomy
Spinal fusion
Day surgery
Clinical efficacy
title Safety and efficacy of day anterior cervical discectomy and fusion procedure for degenerative cervical spondylosis: a retrospective analysis
title_full Safety and efficacy of day anterior cervical discectomy and fusion procedure for degenerative cervical spondylosis: a retrospective analysis
title_fullStr Safety and efficacy of day anterior cervical discectomy and fusion procedure for degenerative cervical spondylosis: a retrospective analysis
title_full_unstemmed Safety and efficacy of day anterior cervical discectomy and fusion procedure for degenerative cervical spondylosis: a retrospective analysis
title_short Safety and efficacy of day anterior cervical discectomy and fusion procedure for degenerative cervical spondylosis: a retrospective analysis
title_sort safety and efficacy of day anterior cervical discectomy and fusion procedure for degenerative cervical spondylosis a retrospective analysis
topic Cervical spondylosis
Diskectomy
Spinal fusion
Day surgery
Clinical efficacy
url https://doi.org/10.1186/s12891-024-07356-7
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