Comparison of Surgical Outcome Between Anterior Cervical Discectomy and Fusion (ACDF) with Transcorporeal Anterior Cervical Microforaminotomy for Brachalgia
Journal Title: Scholars Journal of Applied Medical Sciences - Year 2018, Vol 6, Issue 10
Abstract
Anterior Cervical Discectomy and Fusion (ACDF) is generally performed for brachalgia and is linked with significant complication such as spinal cord injury recurrent laryngeal palsy, infection or swallowing issue. The Anterior cervical microforaminotomy (ACMF) approach includes for the immediate evacuation of the compressive variation from the norm and the conservation of the movement fragments without bone combination or post-agent immobilization. The general aim of the study is to assess the surgical outcome between Anterior Cervical Discectomy and Fusion with Transcorporeal Anterior Cervical Microforaminotomy. Single institutional retrospective analysis. The outcome of both interventions were compared through statistical method. A total 60 ACDF and 40 ACMF were performed. There were no difference in the preoperative neck and VAS score. A single prospective study of modified transcorporeal anterior cervical microforaminotomy was analysed in a private hospital (Comfort Hospital), Dhaka, Bangladesh. Patients having pure brachialgia who was not relieved by conservative treatment over 6-8 weeks in cervical disc prolapse was included in the study. Patients having more than one level disease, features of myelopathy or instability were excluded from the study. In the investigation, ACMF the Vas Score 7, 8 and 9 was among 52.5 percent, 42.5 percent and 5 percent of the aggregate patients individually after the medical procedure. Besides, Preop/Postop was 0 and 1 in the 20 and 80 patients respectively. On the other hand in ASDF the Preoperative VAS Score 7 among 51.67% patients followed by 8 and 9 were among 45%, and 3.3% respectively. On the other hand Post operative VAS Score 0 among 75% patients followed by 2 were only 11.67% and 1 were 13.33%. Bath ACDF and ACMF delivered significant improvement in VAS neck and Arm scores. Degree of improvement of VAS neck and VAS arm are almost similar between both groups with a trend favoring the ACMF group. In ACMF Immediately after surgery all patients were pain free, but 2 out of 40 patients developed brachialgia after one to two months and needed anterior cervical discectomy and fusion. ACMF can be in important alternative to ACDF in treating patients with brachalgia without a significant risk for ACDF revision surgery at the index level. With astute patient selection an ACMF is a safe operation, giving good results in over 90 %. The advantages of the operation include preservation of the motion segment, direct removal of the compressive abnormality, avoidance for the need for fusion and faster recovery.
Authors and Affiliations
Dr. Md Moshiur Rahman, Dr. S. I. M. Khairun Nabi Khan, Dr. Robert Ahmed Khan, Dr. Mainul Haque Sarker, Md. Raziul Haque, Dr. Umme Kulsum Sharmin Zaman
Keywords
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