Impact of Age and Duration of Symptoms on Surgical Outcome of Single-Level Microscopic Anterior Cervical Discectomy and Fusion in the Patients with Cervical Spondylotic Radiculopathy
We aim to evaluate the impact of age and duration of symptoms on surgical outcome of the patients with cervical spondylotic radiculopathy (CSR) who had been treated by single-level microscopic anterior cervical discectomy and fusion (ACDF). We retrospectively evaluated 68 patients (48 female and 20 male) with a mean age of (ranged from 24 to 72 years old) in our Orthopedic Department, Imam Reza Hospital. They were followed up for months (ranged from 25 to 65 months). Pain and disability were assessed by Visual Analogue Scale (VAS) and Neck Disability Index (NDI) questionnaires in preoperative and last follow-up visits. Functional outcome was eventually evaluated by Odom’s criteria. Surgery could significantly improve pain and disability from preoperative and to and (1–21) at the last follow-up visit, respectively. Satisfactory outcomes were observed in 89.7%. Symptom duration of more and less than six months had no effect on surgical outcome, but the results showed a statistically significant difference in NDI improvement in favor of the patients aged more than 45 years (), although pain improvement was similar in the two groups. 1. Introduction Cervical spondylosis is a very common ailment [1]. These patients may present with regional cervical complaints, radiculopathy, or myelopathy [2]. These clinical manifestations existed alone or in combination with each other and most of the cases respond favorably to the conservative treatment [2, 3]. In refractory cases operative intervention may be considered. Although some authors believe that posterior foraminotomy with or without discectomy is applicable and preferred in some types of cervical disc herniation, the standard surgical technique is still anterior cervical discectomy and fusion (ACDF) [4–8]. While autogenous iliac crest bone graft is quoted to be the most common graft used autogenously throughout the world, nowadays most surgeons prefer not to use it to prevent its adverse short- and long-term morbidities [9]. Instead, commercial interbody cages with their various shapes and designs are commonly used. These spacers provide immediate structural stability and can be filled with various bone substitutes to promote interbody fusion [10, 11]. Anterior cervical plating can enhance the stability and fusion rate while at the same time reducing the possibility of cage subsidence, but in single-level cervical spondylotic radiculopathy (CSR) anterior plating is not usually necessary and not recommended [12–16]. Review of the literature indicates that there are lots of papers about epidemiology, natural
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