ABSTRACT

Anterior cervical discectomy and fusion (ACDF) with interbody cages has been widely used for cervical degenerative disc disease (DDD) along with the other procedures (simple discectomy, cervical disc arthroplasty, ACDF with plating etc.) The aim of the study is to analyze the clinical outcomes measured by Visual Analog Scale (VAS) scores and Odom’s criteria after ACDF with blade polyetheretherketone (PEEK) cage plus bioactive bone graft substitute.

83 patients operated by a single neurosurgeon on for singel-level or multi-level ACDF with bladed PEEK cage was evaluated retrospectively. Clinical outcome scores measured by VAS scores and Odom’s criteria; postoperative fusion rates were analyzed on postoperative cervical radiographs. Early postoperative complications, implant failures and progression to adjacent segment disease were investigated.

In our study, one-level ACDF was performed on 51 patients, two-level ACDF was performed on 29 patients and three level ACDF was performed on 3 patients. 91.6 % (76 patients) of the patients presented with radiculopathy, whereas, 8.4 % (7 patients) of the patients presented with radiculomyelopathy. Mean follow-up is 18 months (range 1-32 months). VAS scores were improved in 97.6 % of the patients. According to Odom’s criteria, 95 % of the patients evaluated the surgery success as excellent; 5% of the patients evaluated the surgery success as good. All of the patients with radiculopathic symptoms fully recovered, whereas, 4 patients (57.2 %) with radiculomyelopathy had improved, whereas in 3 patients (42.8 %) neurological status did not changed postoperatively. Symptomatic adjacent segment disease was not encountered in any of the cases. As for early postoperative complications, one patient had a cerebro-spinal fluid (CSF) fistula which required second operation along with a lumbar drainage, 30 % of the patients had transient difficulty of swallowing which resolved in 2-3 days, in 92 % of patients fusion was achived. No mortality was noted.

ACDF procedure is an effective treatment for cervical DDD. ACDF with bladed cages have higher fusion rates and less implant subsidence. Our study has favorable fusion results with acceptable complication rates.