%0 Journal Article
%T Clinical Outcomes After Four
%A Alan S. Hilibrand
%A Alexander R. Vaccaro
%A Christopher K. Kepler
%A Douglas A. Hollern
%A Eric M. Padegimas
%A Gregory D. Schroeder
%A Tyler M. Kreitz
%J Global Spine Journal
%@ 2192-5690
%D 2018
%R 10.1177/2192568218770763
%X Retrospective cohort study. Anterior cervical discectomy and fusion (ACDF) demonstrates reliable improvement in neurologic symptoms associated with anterior compression of the cervical spine. There is a paucity of data on outcomes following 4-level ACDFs. The purpose of this study was to evaluate clinical outcomes for patients undergoing 4-level ACDF. All 4-level ACDFs with at least 1-year clinical follow-up were identified. Clinical outcomes, including fusion rates, neurologic outcomes, and reoperation rates were determined. Retrospective review of our institutional database revealed 25 patients who underwent 4-level ACDF with at least 1-year clinical follow-up. Average age was 57.5 years (range 38.2-75.0 years); 14 (56%) were male, and average body mass index was 30.2 kg/m2 (range 19.9-43.4 kg/m2). Two (8%) required secondary cervical surgery at an average of 94.5 days postoperatively while the remaining 23 did not with an average follow-up of 19 months. Of 23 patients not requiring revision surgery, 16 (69%) patients fused by definition of less than 1 mm of spinous process motion per fused level in flexion and extension. Fifteen (65%) had at least one muscle group with one grade of weakness preoperatively. Nineteen of these patients (83%) had improved to full strength while no patients lost muscle strength. Review of our institution¡¯s experience demonstrated a low rate of revision cervical surgery for any reason of 8% at mean 19 months follow-up, and neurological examinations consistently improved, despite a high rate of radiographic nonunion (31%)
%K anterior cervical discectomy and fusion (ACDF)
%K multilevel
%K degenerative disc disease
%K outcomes
%U https://journals.sagepub.com/doi/full/10.1177/2192568218770763