Treatment of the two-level degenerative cervical disk diseases based on algorithmic anterior approach: a multicenter prospective study
Byvaltsev V.A. Kalinin A.A. Aliyev M.A. Aglakov B.M. Kuharev A.V. Azhibekov N.O.
December 2023Springer Science and Business Media Deutschland GmbH
Neurosurgical Review
2023#46Issue 1
To analyze the effectiveness of an algorithmic anterior approach to the surgical treatment of patients with two-level cervical degenerative disk disease based on the preoperative clinical and imaging parameters. The study included 244 patients with two-level cervical degenerative disk disease. Three groups of patients were evaluated at 3 neurosurgical centers between 2016–2019. The prospective group (Group I, n = 126) consisted of patients who were treated using an algorithm to decide whether they should be treated with a two-level Total Disk replacement (TDR), Anterior Cervical Discectomy and Fusion (ACDF) and hybrid technique. The control group (Group II, n = 118) consisted of patients who underwent two-level anterior decompression with TDR, ACDF and hybrid stabilization between 2005–2015. Visual Analogue Scale (VAS) neck pain, VAS upper limbs pain, Neck Disability Index (NDI), SF-36, Macnab and Nurick scales were collected. Perioperative complications were identified. At 2 years of follow up Group I had significantly better clinical outcomes based on VAS neck pain score (p = 0.02), VAS upper limbs pain (p = 0.04), NDI score (p = 0.02), SF-36 score (p = 0.01), satisfaction with surgery on the Macnab scale (p < 0.001) and outcome of surgery based on Nurick scale (p < 0.001). Complication rate was lower in Group I, 6.3% compared to 24.6% in Group II, p = 0.0001. The algorithmic anterior approach to the surgical treatment of patients with two-level cervical degenerative disk disease resulted in significant improvement of functional outcomes and a decrease in complications at a minimum 2 years of follow-up.
Anterior cervical discectomy and fusion , Cervical spine , Hybrid stabilization , Surgical algorithm , Total disk replacement , Two-level degenerative disk disease
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Department of Neurosurgery, Irkutsk State Medical University, 1 Krassnogo Vosstaniya Street, off 201, Irkutskaya Oblast’, Irkutsk, 664003, Russian Federation
Department of Neurosurgery, Railway Clinical Hospital, Irkutsk, Russian Federation
Department of Traumatology, Orthopedic and Neurosurgery, Irkutsk State Medical Academy of Postgraduate Education, Irkutsk, Russian Federation
Department of Neurosurgery, Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan
Department of Neurosurgery, Federal Siberian Scientific and Clinical Center of the Federal Medical and Biological Agency, Krasnoyarsk, Russian Federation
Kazakhstan Medical University “Higher School of Public Health”, Almaty, Kazakhstan
Department of Neurosurgery
Department of Neurosurgery
Department of Traumatology
Department of Neurosurgery
Department of Neurosurgery
Kazakhstan Medical University “Higher School of Public Health”
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