CLINICAL OUTCOMES OF ANTERIOR CERVICAL DISCECTOMY AND FUSION IN CERVICAL RADICULOPATHY: A PROSPECTIVE ANALYSIS FROM IRFAN GENERAL HOSPITAL IN PESHAWAR

Abstract

Introduction: Cervical radiculopathy is commonly attributed to compression of nerve roots secondary to a herniated disc or cervical foraminal stenosis due to degeneration of the cervical spine. Surgical techniques most commonly used in cervical radiculopathy are anterior cervical discectomy and fusion (ACDF), posterior cervical foraminotomy (PCF) and cervical disc replacement (CDR). The aim of this study was to evaluate the clinical outcomes of ACDF in cervical radiculopathy in terms of Neck disability index, hospital stay, mortality rate, success rate and complications.

Material & Methods: This prospective study was conducted in Ali Institute of Neurosciences, Irfan General Hospital Peshawar from January 2019 to April 2021. The sampling technique was nonprobability convenience sampling. Patients having diagnosis of cervical radiculopathy through subjective, objective and investigation findings were enrolled in the study.  Standard procedure of ACDF was performed after informed consent and outcome measures were assessed post-surgery and after follow-up of eight weeks. Demographic variables such as age, gender, level of surgery and occupation were recorded on a proforma.  Neck Pain and Disability scale (NPAD) questionnaire was filled by the participants at eight weeks follow up. Data were analyzed using SPSS version 26.

Results: Data was collected and analyzed of 202 patients as 38 patients did not come for follow ups. Majority of the participants were male 145(72%) while 57(28%) were females. Mean age of the participants were 47 with standard deviation of 3 (Range 31 to 60). When asked about the occupation, 67(33%) were drivers ,81(40%) belonged to labour work while 48(24%) were office workers. Overall the pain and disability scores showed significant improvement as measured by Neck disability index as overall mean score was reported to be 19 post operatively as compared to 45 points pre operatively.

Conclusion: The results of our study concluded that anterior cervical discectomy and fusion is a safe and effective surgical procedure in the treatment of cervical radiculopathy associated with improved patient outcomes and satisfaction. However, the procedure is also associated with complications.