Anterior Cervical Discectomy and Fusion: A Three Year Retrospective Study

1
Anterior Cervical Discectomy and Fusion A Three
Year Retrospective Study

• M. Craig Hixson
• Undergraduate
• Tennessee Technological University

2
Objectives

• 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.

3
Background

• 1995 McAfee et al
• 100 Subjects
• 2 year minimum follow-up
• 0 Neurological Decline
• 10 instances of complications

4
Background

• 2004 Moreland et al
• 131 subjects
• Effects of allograft and Rabea cage vs. autograft
• No statistically significant differences

5
Background

• 2005 Kwon et al
• ACDF is effective method of treatment
• Necessity of proper instrumentation-aided
  alignment overstated in previous studies

6
Objective

• 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.

7
Methods

• Data Form
• VAS index
• Oswestry Index

8
Data Form
9
VAS index
10
Oswestry Index

• 10 Section Questionnaire that evaluates a
  patients functional capacity

11
Methods

• All data obtained from follow up visits is
  compared to pre-operative results of same
  questionairres.

12
Results

• 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

13
Time Line

• 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

14
Budget

• All follow up visits were on voluntary basis.
• Radiographic review provided voluntarily by
  independent radiologist.
• Materials for presentation should be of nominal
  cost.