Anterior cervical discectomy and fusion in young adults leads to favorable outcome in long-term follow-up

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Hirvonen , T , Siironen , J , Marjamaa , J , Niemelä , M & Koski-Palkén , A 2020 , ' Anterior cervical discectomy and fusion in young adults leads to favorable outcome in long-term follow-up ' , The spine journal : official journal of the North American Spine Society , vol. 20 , no. 7 , pp. 1073-1084 . https://doi.org/10.1016/j.spinee.2020.03.016

Title: Anterior cervical discectomy and fusion in young adults leads to favorable outcome in long-term follow-up
Author: Hirvonen, Tuomas; Siironen, Jari; Marjamaa, Johan; Niemelä, Mika; Koski-Palkén, Anniina
Other contributor: University of Helsinki, Neurokirurgian yksikkö
University of Helsinki, Clinicum
University of Helsinki, HUS Neurocenter
University of Helsinki, Department of Neurosciences
University of Helsinki, Neurokirurgian yksikkö





Date: 2020-07
Language: eng
Number of pages: 12
Belongs to series: The spine journal : official journal of the North American Spine Society
ISSN: 1529-9430
DOI: https://doi.org/10.1016/j.spinee.2020.03.016
URI: http://hdl.handle.net/10138/328820
Abstract: Background Context Anterior cervical discectomy and fusion (ACDF) procedures is thought to lead to accelerated degeneration of the adjacent cervical discs and in some cases can be symptomatic (adjacent segment disease, or ASD). The occurrence of ASD is of particular interest when treating young individuals, as the cumulative disease burden may become increasingly significant during their expectedly long lifetime. However, the overall impact of a surgical intervention on the lifetime prognosis of ASD remains unclear. Purpose Our goal was to study the long-term outcomes of ACDF surgery among those members of the young adult population who have been operated on between the ages of 18 and 40. Study design Retrospective study. Patient Sample All patients between 18 and 40 years of age at the time of surgery who underwent ACDF due to degenerative cervical disorders at Helsinki University Hospital between the years of 1990 and 2005 (476 patients). Outcome Measures Cervical reoperation rate, satisfaction with the surgery, employment status, Neck Disability Index (NDI) Methods We retrospectively analyzed the medical records of all patients between 18 and 40 years of age at the time of surgery who underwent ACDF due to degenerative cervical disorders at Helsinki University Hospital between the years of 1990 and 2005. We sent questionnaires to all available patients at the end of the follow-up (median 17.5 years) to assess their current neck symptoms, general situations, and levels of satisfaction with the surgery. Furthermore, we compared the results for different types of ACDF surgeries (i.e., discectomy only versus synthetic cage or bone autograft implantation for fusion) in propensity-score-matched groups. Results Of the 476 patients who were included in the study, surgery was performed in 72% of the cases due to intervertebral disc herniation and in 28% due to spondylotic changes. The total reoperation rate during the entire follow-up (median 17.5 years) was 24%, and 19.5% if early reoperations (
Subject: 3126 Surgery, anesthesiology, intensive care, radiology
anterior decompression
cervical disc herniation
cervical spondylosis
reoperation
long-term outcome
Reoperation
NECK DISABILITY INDEX
SINGLE
ALLOGRAFT
RELIABILITY
SMOKING
Cervical spondylosis
ADJACENT-SEGMENT PATHOLOGY
PAIN
Long-term outcome
RADICULOPATHY
Cervical disc herniation
Anterior decompression
DISEASE
PLATE
3112 Neurosciences
3124 Neurology and psychiatry
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