Impact of Age and Duration of Symptoms on Surgical Outcome of Single-Level Microscopic Anterior Cervical Discectomy and Fusion in the Patients with Cervical Spondylotic Radiculopathy

Abstract

We aim to evaluate the impact of age and duration of symptoms on surgical outcome of the patients with cervical spondylotic radiculopathy (CSR) who had been treated by single-level microscopic anterior cervical discectomy and fusion (ACDF). We retrospectively evaluated 68 patients (48 female and 20 male) with a mean age of 41.2 ± 4.3 (ranged from 24 to 72 years old) in our Orthopedic Department, Imam Reza Hospital. They were followed up for 31.25 ± 4.1 months (ranged from 25 to 65 months). Pain and disability were assessed by Visual Analogue Scale (VAS) and Neck Disability Index (NDI) questionnaires in preoperative and last follow-up visits. Functional outcome was eventually evaluated by Odom's criteria. Surgery could significantly improve pain and disability from preoperative 6.2 ± 1.4 and 22.2 ± 6.2 to 3.5 ± 2.0 and 8.7 ± 5.2 (1–21) at the last follow-up visit, respectively. Satisfactory outcomes were observed in 89.7%. Symptom duration of more and less than six months had no effect on surgical outcome, but the results showed a statistically significant difference in NDI improvement in favor of the patients aged more than 45 years (P = 0.032), although pain improvement was similar in the two groups.

Anterior cervical discectomy and fusion: is surgical education safe?

“…The difference in mortality, however, was more attributed to comorbidities and systemic complications rather than factors directly related to surgery [13]. The postoperative clinical outcomes are usually equally good in older patients [14,15]. As most patients in our study were older than 65 years old and the study focused on surgical complications as well as on the postoperative outcome, the mean age difference of 5 years between the study groups is very unlikely to have influenced our primary or secondary endpoints.…”

Comparison of surgical outcomes after anterior cervical discectomy and fusion: does the intra-operative use of a microscope improve surgical outcomes

“…Omidi-Kashani et al in a recent study of 74 patients undergoing ACDF's with the use of an intra-operative microscope demonstrated excellent outcomes in the majority of patients (11). Under Odom's criteria, the authors found that 89.7% of patients reported functional outcomes as either good or excellent (11,12).…”

An Outcome Study of Anterior Cervical Discectomy and Fusion among Iranian Population

“…In our series, duration of preoperative symptoms did not have a statistically significant effect on any of our outcome measures. Omidi-Kashani et al [ 22 ] demonstrated no correlation between duration of symptoms and surgical outcome in their evaluation on cases with cervical spondylotic radiculopathy who were treated with ACDF. Lied et al [ 17 ] also achieved no significant correlation between preoperative duration of pain and pain relief.…”