Ihsan Ullah, Akhtar Muneer, Bakht Jamal, Khalid Khanzada.
Functional outcome of anterior cervical discectomy and fusion for degenerative diseases of the cervical spine..
Pak J Neuro Surg Jan ;25(1):102-7.

Background & Objectives:  Discectomy followed by the fusion in the cervical spine is done for herniated cervical intervertebral disc causing neurologic symptoms when conservative management has failed. In our study, we assessed clinical presentation and functional outcomes after surgery through an anterior cervical approach. Materials and Methods:  This retrospective cohort study was conducted in the Neurosurgery division, Lady reading hospital Peshawar. We included 42 consecutive patients who underwent single-level anterior cervical discectomy and fusion for the herniated cervical disc. The mean follow-up was 14 months. Anterior cervical discectomy and fusion (ACDF) was done in all patients using standalone titanium or PEEK cage. Z scores and associated p values were calculated to see the difference of significance between preoperative reported symptoms and their improvements postoperatively. Results:  There were 37 male and 5 female patients. The mean age was 43 ± 9.8 years. Disc herniation mostly occurred at C4 – 5 and C5 – 6 levels (76.16%). Preoperatively, the Neck pain was present in 36 (85.7%), upper limb weakness in 20 (47.6%), numbness/paresthesias in 25 (59.5%), upper limb pain in 18 (42.84%), lower limbs spasticity in 14 (33.32%) and bladder involvement in 3 (7.14%) patients. Statistical significant postoperative improvements in (90-100%) were reported in symptoms. Postoperative complications were observed in 5 patients. Most reported complication, the dysphagia was noted in 9.52% patients. Conclusions:  A significant proportion of patients with herniated cervical disc showed an excellent recovery after anterior cervical discectomy and fusion (ACDF).

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