Anterior Cervical Microdiscectomy Appears Effective in Treating Certain Cervical Disc InjuriesOne method of treating cervical (neck) disc injuries is with a surgical procedure called anterior cervical microdiscectomy, or ACD. In this surgery, the vertebrae (bones) can be fused together, depending on the procedure. However, there is some debate among surgeons as to wheter this is a good idea.
In this study, researchers conducted a randomized trial to see how patients responded immediately after ACD, without fusion, and then how they were 1 year later. Twenty patients who had not had cervical surgery before and who urgently needed surgery or were not responding to non-surgical treatment participated. Eleven patients (7 women) were in group A and did not have a fusion. Group B had 9 patients (7 men) and they did have fusions. Groups A's ages ranged from 21 to 58 years, with the average being 39.9; group B's ages ranged from 30 to 50 years, with the average being 40.2 years. The patients' major complaint was arm pain.
After the surgery, all patients were told to wear soft collars for 2 weeks. They participated in physical therapy and rehabilitation. Their progress was monitored by the specialists and pain was rated using the Visual Analog Scale (VAS). X-rays were taken before surgery, 1 day after, and again 1 year later.
The researchers found that the scores for group A, from the VAS for arm pain before surgery, was an average of 8.18 and it decreased to 3.27 1 year later. Group B reported VAS of 8 before surgery and 3.11 after a year. The neck pain scored 3.18 before surgery and 2.81 a year later in group A, 3.22 before and 2 after in group B. The authors didn't consider the difference significant for group A, but it was significant for group B. No differences were seen in any of the other aspects studied.
The authors concluded that the ACD technique was safe and effective whether fusion was performed or not. They did suggest, however, that another study with larger numbers of patients may result in different findings.
Tunc Oketnoglu, MD, et al. Anterior Cervical Microdiscectomy with or without Fusion. In Journal of Spinal Disorders and Techniques. July 2007. No. 5. Pp. 361-368.
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