A Prospective Randomized Study of Anterior Single-level Cervical Disc Operations with Long-term Follow-up: Surgical Fusion Is Unnecessary

Abstract

According to this study, satisfactory results can be achieved by performing simple discectomy to treat single-level cervical root compressive disease.

A systematic literature review to identify the best method for a single level anterior cervical interbody fusion

“…For completeness, these five studies have been included in Table 3, which gives an overview of the checklist score for each criterion on the checklist for the eight RCTs, but they were not analysed further. The remaining three studies were of sufficient methodological quality to be included in the review [20,32,35]. Table 4 gives an overview of the outcome measurements used in the three selected studies.…”

“…Outcome measurements were bony union on plain X-rays and a clinical outcome that was constructed on the basis of the pain scores obtained from independent reports made by the patient and an observer. [32] fusion Kyphosis benefit but still complaints); poor (no benefits or worse than preoperatively)…”

“…Savolainen et al [32] compared discectomy alone to two different fusion techniques: Smith-Robinson or Caspar plating. Outcome measurements were based on plain X-ray to determine fusion and kyphosis together with a clinical outcome questionnaire to evaluate benefit and complaints on a three-point scale.…”

“…From the study by Martins [20] we cannot conclude that there is a difference between discectomy alone and addition of an autograft in a Cloward procedure. From the study by Savolainen et al [32], it seems that additional plating does not improve outcome.…”

Single or double-level anterior interbody fusion techniques for cervical degenerative disc disease

“…• There is moderate quality evidence (high risk of bias) from seven studies (Abd-Alrahman 1999; Barlocher 2002; Dowd 1999; Martins 1976;Rosenorn 1983;Savolainen 1998;Xie 2007; N = 487) that the difference in complication rate between discectomy alone and iliac crest autograft is not statistically significant (OR 1.56; 95% CI 0.71 to 3.43; P = 0.27; see Figure 3). In the discectomy group, eight complications were reported (6 re-operations, 1 nerve lesion, 1 staphylococcus aureus infection); in the human bone graft group, thirteen complications (4 re-operations, 2 infection, 2 hematoma, 1 graft loosening, 1 iliac crest pain, 1 iliac crest fracture) were reported.…”