مقايسه نتايج برداشتن ديسك قدامي گردن با فيوژن و بدون آن

COMPARING OUTCOMES OF ANTERIOR CERVICAL DISCECTOMY WITH AND WITHOUT FUSION

Backgrounds & Aims: Cervical disc herniation causing neurological deficit is a common disorder. Several surgical methods have been developed in past century; anterior cervical discectomy with and without fusion is one of them. Since the presentation of anterior cervical discectomy as a surgical treatment of degenerative disc disease controversies have been developed regarding necessity of fusion following anterior cervical discectomy or not. Both of these methods have advantages and disadvantages. This study analyses the clinical results obtained via two methods of surgical treatment: anterior cervical discectomy with fusion (ACDF) and anterior cervical discectomy without fusion (ACD). Material and Methods: Our sampling (40 people) was selected from 35-55 years old with cervical disc herniation and resistant radicular pain to conservative treatments. They were operated randomizlly with ACD or ACDF. The surgery was performed with the same team and with operating microscope. In addition to discectomy in ACDF, interbody fusion was performed with autologus iliac crest bone graft. For assessing the operation results, we used visual analogue scale (VAS) for assessing radicular and neck pain, and Porolo outcome scale for assessing social and economic condition. Results: In ACDF radicular pain decreased from main 6.55± 2.01to 0.48i0.35and-neck pain from 1.6± 0.69to 0.49±0.34and porlo score increased from 4.7±1.97 to 9.1±0.67. In ACD radicular pain decreased from 6.8±1.9 to 0.8±0.47 and neck pain from 1.51:0.68 to 0.53±0.49 and porlo score increased 4.8-12.06 to 9.2±0.76 postoperatively. In ACDF graft related complications were 15%. Conclusion: Both of procedure has excellent improvement of symptoms postoperatively and during follow up ACDF associated with 15% graft related complications, in ACD neck pain was a little more. There is little or no difference in clinical outcome following single level anterior discectomy when the patientʹs dominant symptom is radicular pain, whether fusion is performed or not.