European Journal of Biomedical and Pharmaceutical Sciences

STUDY ON ANTERIOR CERVICAL DISCECTOMY AND FUSION BY CERVICAL CAGE WITH BONE GRAFT FOR THE TREATMENT OF DOUBLE LEVEL CERVICAL SPONDYLOTIC MYELOPATHY

*Dr. D. Mishra, M. Shrestha, K. Ahsan P. Chaudhary S. Batajoo A. K. Pandey and Y. B. Gurung

ABSTRACT

Background: Cervical spondylotic myelopathy (CSM) is a common disorder of spinal cord seen in aged population. Anterior cervical decompression and fusion is a popular and rewarding procedure for the treatment of CSM. Objectives: The aim of the study is to find out the results of ACDF by cervical cage with bone graft for the treatment of double level cervical spondylotic myelopathy. Methods: This prospective observational study was conducted in the Department of Orthopaedics, Bangubandhu Sheikh Mujib Medical University (BSMMU), Dhaka over a period of two years from March 2015 to August 2017.In this study, 40 patients with spondylotic myelopathy including double level of cervical spine were enrolled where diagnosis was on the basis of presenting complains, clinical evaluation and relevant investigations. History of the patients were collected; clinical examination was done and relevant investigation was done for each patient. Neurological evaluation was done by Nurick grading and VAS scale was used for evaluation of pain which were analyzed for evaluation of result. Result: Male were predominant in this study. Male to female ratio was 2.63:1. Mean age of the patients was 45.9 ± 9.1years within the range of 30-65 years. Both sides were affected in 14 (35.0%) cases, only right side was affected in 15 (37.5%) cases and only left side was affected in 11 (27.5%) cases. Involved disc spaces were C3/4 (10.0%), C4/5 (22.5%),C5/6 (42.5%)and C6/7 (25.0%). Transient dysphagia was observed in 2 (5.0%) cases, transient paraparesis in 1 (2.5%) case, wound infection in 1 (2.5%) case and damage to the durra was observed in 1 (2.5%) case. Sign of fusion was observed in 10 (25.0%) cases after 3months, 30 (75.0%) cases after 6 months and in all patients after 12 months. Result was found excellent in 35 (87.5%), good in 5 (12.5%) cases. Conclusion: Anterior cervical discectomy and fusion by cervical cage with bone graft is an effective procedure for double level cervical spondylotic myelopathy.

Keywords: ACDF, Bone graft, Cervical cage, Cervical myelopathy.