| Abstrakt: |
Objective: Anterior cervical discectomy (ACD) and fusion is the standard surgical treatment for cervical radiculopathy. The cervical disc prosthesis is designed to prevent complications such as pseudoarthrosis and adjacent segment degeneration and to preserve spinal motion. Materials and Methods: In this retrospective study, 57 patients who underwent microsurgical ACD between 2015 and 2020 were included. Patients were divided into four groups: I group cervical cage (CC), II group cervical disc prosthesis (CDP) at one level, III group and CDP, and IV group CC+CC at two levels. For cage application, 1 cc of canceled bone graft was used in each case. In our study, the clinical outcomes, operations, and complications of patients who underwent CC and CDP and those who underwent double-level hybrid CC and CDP were evaluated during the 2-year follow-up period. Results: When the groups were compared according to the localization of patient complaints (p=0.235) and neurological findings such as preoperative brachial neuropathy, upper extremity paresis, and cord compression (p=0.781), there was no statistically significant difference (p>0.05). In preoperative cervical magnetic resonance imaging (MRI) reports; In the CDP group, protrusion and extrusion were reported in the midline in 13 (22.8%) patients and in the lateral location in 17 (29.8%) patients. Osteophyte formation was more frequently encountered in the midline and lateral locations in the CC group (17.5%). Osteophyte formation was not observed in the CDP group. A significant difference was found in the preoperative cervical MRI results (p=0.006) and postoperative cervical spinal alignment averages (p=0.021). In all groups, C 5/6 (64.9%) and C 6/7 (40.4%) were the frequently affected disc spaces. In those who underwent CDP, soft disc was observed in 24 (80.0%) patients, and hard disc, CC, CDP+CC, was observed in 6 (20%) cases. A hard disc was detected in the entire group with CC (two distances). There was a statistically significant difference according to the affected disc nature and spacing (p<0.001). When all groups were compared according to operation times, operation results, and complications, there was no significant difference between the groups (p=0.074). Conclusion: Microsurgical ACD is an effective and reliable method preferred in cervical disc herniations. Although autologous or heterologous bone grafts and cages are used to ensure fusion, CDP, which reduces adjacent segment disease and provides spinal mobility, has been preferred more frequently in recent years. [ABSTRACT FROM AUTHOR] |
