PMID- 34821187
OWN - NLM
STAT- Publisher
LR  - 20240220
IS  - 1360-046X (Electronic)
IS  - 0268-8697 (Linking)
DP  - 2021 Nov 25
TI  - Comparison of outcomes and complications between one- and two-level anterior 
      cervical discectomy and fusion: a population-based study of 410 patients.
PG  - 1-6
LID - 10.1080/02688697.2021.2005778 [doi]
AB  - OBJECTIVE: The objective of this study was to compare outcomes and patient 
      satisfaction, and secondly to compare complication rates between one- and 
      two-level anterior cervical discectomy and fusion (ACDF) for cervical 
      radiculopathy. METHODS: Data from patients receiving one- or two-level ACDF for 
      cervical radiculopathy at two institutions were prospectively collected and 
      retrospectively analysed. Patients were separated into one-level ACDF and 
      two-level ACDF. Comparison analyses of patient-reported outcome measures (PROMs) 
      comprising Visual Analogue Scale for neck pain (VAS-NP) and arm pain (VAS-AP), 
      Neck Disability Index (NDI), and EQ-5D 3-level version (EQ-5D-3L) were performed 
      between baseline and 1-year follow-up and between groups as well as achievement 
      of minimal clinically important differences (MCID) in PROMs and satisfaction. 
      Additionally, complications were compared between groups. RESULTS: A total of 410 
      patients (270 one-level and 140 two-level) were included. PROMs improved 
      significantly from baseline to 1-year follow-up (p < 0.001) in both groups. When 
      comparing PROMs between one- and two-level ACDF, a trend towards greater 
      improvement was observed in patients undergoing one-level ACDF, notably in 
      EQ-5D-3L (p = 0.073). Significantly more patients in the one-level group achieved 
      MCID in VAS-NP compared to patients in the two-level group (56% vs 44%, 
      p = 0.025). Two hundred and ninety-six (67%) patients reported to be satisfied, 
      but the one-level group trended to be more satisfied (70% vs. 62%). One-level 
      ACDF further demonstrated a trend of more favourable complication profiles; 
      however, complication rates were low in both groups. The risk of intraoperative 
      complications was 2.4%, postoperative complications in-hospital were 1.2%, and 
      patient-reported postoperative events post-discharge 42%. CONCLUSIONS: One- and 
      two-level ACDF are effective procedures for degenerative cervical nerve root 
      compression. Yet, significantly more patients in the one-level group achieved 
      MCID in neck pain compared to patients in the two-level group.
FAU - Wichmann, Thea Overgaard
AU  - Wichmann TO
AD  - Department of Neurosurgery, Aarhus University Hospital, Aarhus N, Denmark.
FAU - Bech-Azeddine, Rachid
AU  - Bech-Azeddine R
AD  - Copenhagen Spinal Research Unit - Center of Rheumatology and Spine Diseases 
      Rigshospitalet Glostrup, Glostrup, Denmark.
AD  - Department of Clinical Medicine, University of Copenhagen, Copenhagen N, Denmark.
FAU - Norling, Anna Louise
AU  - Norling AL
AD  - Copenhagen Spinal Research Unit - Center of Rheumatology and Spine Diseases 
      Rigshospitalet Glostrup, Glostrup, Denmark.
FAU - Einarsson, Halldor Bjarki
AU  - Einarsson HB
AD  - Department of Neurosurgery, Aarhus University Hospital, Aarhus N, Denmark.
FAU - Rasmussen, Mikkel Mylius
AU  - Rasmussen MM
AD  - Department of Neurosurgery, Aarhus University Hospital, Aarhus N, Denmark.
LA  - eng
PT  - Journal Article
DEP - 20211125
PL  - England
TA  - Br J Neurosurg
JT  - British journal of neurosurgery
JID - 8800054
SB  - IM
OTO - NOTNLM
OT  - Anterior cervical discectomy and fusion
OT  - cervical radiculopathy
OT  - complications
OT  - outcomes
EDAT- 2021/11/26 06:00
MHDA- 2021/11/26 06:00
CRDT- 2021/11/25 08:42
PHST- 2021/11/25 08:42 [entrez]
PHST- 2021/11/26 06:00 [pubmed]
PHST- 2021/11/26 06:00 [medline]
AID - 10.1080/02688697.2021.2005778 [doi]
PST - aheadofprint
SO  - Br J Neurosurg. 2021 Nov 25:1-6. doi: 10.1080/02688697.2021.2005778.