Transcript Anterior Cervical Discectomy and Fusion: A Three Year

Anterior Cervical Discectomy and
Fusion: A Three Year
Retrospective Study
M. Craig Hixson
Undergraduate
Tennessee Technological University
Objectives
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This study is designed to evaluate the effectiveness of discectomy
and fusion of the cervical spine through an anterior approach
(ACDF) through post-operative questionnaires and radiographic
analysis. The effects of the usage of several different types on
internal instrumentation shall also be evaluated.
This study will solidify existing evidence that ACDF is an effective
method for treating patients who present with various anomalies of
the cervical spine. Furthermore, comparing results of patients upon
which varying methods of internal fixation were used shall provide
new evidence regarding the superiority of particular styles of
instrumentation.
Background
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1995 McAfee et al
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100 Subjects
2 year minimum follow-up
0% Neurological Decline
10 instances of complications
Background
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2004 Moreland et al
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131 subjects
Effects of allograft and Rabea cage vs.
autograft
No statistically significant differences
Background
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2005 Kwon et al
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ACDF is effective method of treatment
Necessity of proper instrumentation-aided
alignment overstated in previous studies
Objective
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Show effectiveness of ACDF
Examine differences in outcomes for patients
with different internal instrumentation.
ACDF is an effective method of treating patients
with cervical spine pain and radiculopathy.
Furthermore, favorable outcomes are
independent of type of internal instrumentation.
Methods
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Data Form
VAS index
Oswestry Index
Data Form
MR#
NAME
BIRTH YEAR
GENDER
SURGEON
DATE OF SURGERY
PROCEDURE
INSTRUMENTATION
LEVELS FUSED
GRAFT MATERIAL
COMPLICATIONS
PRE-OP ANALOG PAIN SCALE
POST-OP ANALOG PAIN SCALE
PRE-OP OSWESTRY
POST-OP OSWESTRY
CHRONIC MEDICAL PROBLEMS
TOBACCO USE
WORK RELATED
LITIGATION
WORK PRE-OP
WORK POST-OP
SAME JOB
NECK PAIN
ARM PAIN
NON-OPERATIVE CARE
LENGTH OF SYMPTOMS
WOULD YOU HAVE SURGERY AGAIN
PHYSICAL THERAPY POST-OP
COMENTS
VAS index
Oswestry Index
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10 Section Questionnaire that evaluates a
patients functional capacity
Methods
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All data obtained from follow up visits is
compared to pre-operative results of same
questionairres.
Results
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3 year follow up will provide long term data.
102 patients sufficient population to imply
statistical significance
Studies of instrumentation are usually conducted
by parties with financial ties to the hardware
being studied. This study will provide an
objective analysis of their effectiveness
Time Line
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All data has been collected
Data will be statistically analyzed by Nov.9
Manuscript drafted and submitted for
review by Nov. 16
Poster presentation of findings by Nov. 23
Final manuscript prepared by Nov.30
Budget
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All follow up visits were on voluntary
basis.
Radiographic review provided voluntarily
by independent radiologist.
Materials for presentation should be of
nominal cost.