Single level anterior cervical discetomy without interbody fusion: a prospective analysis of outcome

ABSTRACT

To evaluate the outcome in patients who underwent anterior cervical discectomy without interbody fusion. Prospective study. Imam Hospital, Tabriz, Iran. Forty-one patients with single level cervical disc herniation were included in the study. Simple anterior cervical discectomy technique without fusion was performed in all patients by one surgeon. Morbidity and functional disability. The study was carried out between March 1999 and March 2003. The mean age was 41 years. Thirty-one [75.6%] patients were male whereas ten [24.4%] were female. C5-C6 level was the most common site of discal herniation. Presentation was as follows 80% radiculopathy, 5% myelopathy, and 15% radiculomyelopathy. 80% patients had soft disc and 20% hard disc herniation. Twenty-five [61%] patients had excellent, 13 [31.5%] good, 2 [5%] satisfactory and 1 [2.5%] poor outcome. Result was significantly better in patients with radiculopathy than in patients with myelopathy or radiculomyelopathy [p < 0.001]. All patients with soft disc herniation and 62.5% patients with hard disc herniation had good or excellent results [p < 0.05]. Outcome was not significantly related to sex, age, and disc level [p > 0.05]. Postoperative complications included transient neck and interscapular pain [46.3%], and transient hoarseness [9.7%]. Transient dysphagia [lasting for less than two weeks] was also seen in three out of four patients with hoarseness. Postoperative neck pain was more frequent in patients with hard disc herniation [p = 0.016]. Definite fusion was seen in 75.6%, partial fusion in 9.8%, and non-union in 14.6% cases. 87.8% patients were able to return to work postoperatively. Single level cervical discectomy without fusion was found to have satisfactory outcomes. This method may provide a good approach for achieving root and cord decompression without the potential for graftrelated complications