Complications After 3- and 4-Level Anterior Cervical Diskectomy and Fusion.


Journal

World neurosurgery
ISSN: 1878-8769
Titre abrégé: World Neurosurg
Pays: United States
ID NLM: 101528275

Informations de publication

Date de publication:
Oct 2019
Historique:
received: 13 01 2019
revised: 09 07 2019
accepted: 10 07 2019
pubmed: 20 7 2019
medline: 22 1 2020
entrez: 20 7 2019
Statut: ppublish

Résumé

Anterior cervical diskectomy and fusion (ACDF) is a standard surgical procedure used widely in the treatment of degenerative cervical spine conditions. Although the safety and effectiveness of single-level ACDF is well supported in the literature, reports of multilevel ACDF are sparse and present mixed results. There is concern for greater complications with increasing levels of fusion given the increased complexity, procedure duration, and invasiveness of multilevel ACDF. In this retrospective review, we report complications data for 105 adult neurosurgical patients who underwent elective multilevel ACDF at a single institution by a single surgeon between 2004 and 2016. Fifty-four patients underwent 3-level ACDF and 51 patients underwent 4-level ACDF with a mean follow-up of 2.7 ± 1.9 years. Although patients with 4-level fusion were more likely than those with 3-level fusion to have estimated blood loss ≥100 mL (P = 0.04), we found no significant differences in other peri- and postoperative complications, need for revision, and presence of symptoms at the time of last follow-up between groups. This study suggests that 4-level ACDF is not necessarily associated with a greater number of or more severe complications than 3-level ACDF.

Sections du résumé

BACKGROUND BACKGROUND
Anterior cervical diskectomy and fusion (ACDF) is a standard surgical procedure used widely in the treatment of degenerative cervical spine conditions. Although the safety and effectiveness of single-level ACDF is well supported in the literature, reports of multilevel ACDF are sparse and present mixed results. There is concern for greater complications with increasing levels of fusion given the increased complexity, procedure duration, and invasiveness of multilevel ACDF.
METHODS METHODS
In this retrospective review, we report complications data for 105 adult neurosurgical patients who underwent elective multilevel ACDF at a single institution by a single surgeon between 2004 and 2016.
RESULTS RESULTS
Fifty-four patients underwent 3-level ACDF and 51 patients underwent 4-level ACDF with a mean follow-up of 2.7 ± 1.9 years. Although patients with 4-level fusion were more likely than those with 3-level fusion to have estimated blood loss ≥100 mL (P = 0.04), we found no significant differences in other peri- and postoperative complications, need for revision, and presence of symptoms at the time of last follow-up between groups.
CONCLUSIONS CONCLUSIONS
This study suggests that 4-level ACDF is not necessarily associated with a greater number of or more severe complications than 3-level ACDF.

Identifiants

pubmed: 31323419
pii: S1878-8750(19)32005-4
doi: 10.1016/j.wneu.2019.07.099
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

e1105-e1110

Informations de copyright

Copyright © 2019 Elsevier Inc. All rights reserved.

Auteurs

Song Kim (S)

University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA. Electronic address: sok50@pitt.edu.

Nima Alan (N)

Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.

Alexandra Sansosti (A)

University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.

Nitin Agarwal (N)

Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.

Daniel A Wecht (DA)

Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.

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