Anterior Cervical Discectomy Using Cage Plate

Abstract

Introduction: Cervical disc degenerative disease is the commonest disorder of the cervical spine. It faces the physiotherapist, orthopaedic surgeon, and neurosurgeon in their daily clinical practice. Soft disc herniations usually affect one level, whereas hard disc herniations can affect multiple levels. Central lesions usually result in cord compression symptoms, and lateral lesions usually result in radicular symptoms. Several terms are commonly used to describe the degenerative cervical spine; the most frequent term is cervical spondylosis, and other synonyms are osteoarthritis, osteoarthrosis, chronic herniated disc, and spur formation. Spondylosis is a term referring to degenerative osteoarthritis of the joints between the centra of the spinal vertebrae and/or neural foraminate. Objective: This paper aims to study the anterior Cervical Discectomy Using Cage Plate. Patients and Methods: This is a prospective study conducted on 30 patient’s candidates for ACDF who were admitted to the orthopaedic department of Basrah University Teaching Hospital, complaining of neck pain, paraesthesia, and numbness in upper limbs and/ or weakness in the lower limbs, during the period from June 2020 till July 2021. All patients were evaluated by detailed history and thorough physical examination with special emphasis on neurological examination and radiological investigations. Detailed history was taken according to a special formula prepared for this purpose; special emphasis was placed upon age, sex, occupation, and regarding neck pain: its site, side, duration, attacks, character, radiation, relieving or aggravating factors, and associated phenomena like neck stiffness or vertigo were recorded too. Neurological symptoms, including numbness, Parasthesia, muscle weakness, and their side, site, distribution, and sphincter disturbances, were asked about. Results and discussions: Cervical disc disease, which includes (soft or hard disc protrusion or herniation and degenerative disc disease); is the most common disorder of the cervical spine. Soft disc herniations usually affect one level, whereas hard disc herniations can affect multiple levels (I>. Central lesions usually result in cord compression symptoms, and lateral lesions usually result in radicular symptoms. Cervical disc degeneration can be manifested as axial pain, radiculopathy, or myelopathy. The process can be acute, as seen with disc herniations, and cause symptoms resembling those of an acute lumbar disc herniation (i.e., the clear radicular pattern of pain, motor, and sensory deficits); or more indolent from chronic cervical disc degeneration Degenerative problems of the cervical spine generally occur in the middle or later years of life. In our series, the age of patients ranged from 32-70 years with an average of 49.26 years, 86.7% being above 40 yrs, With male to female ratio of 1.7: 1; so our result is similar to what was written by Jan Van Der Bauwhede, Eugene Sherry, (Kelsey, et al., indicated that cervical disc rupture was more common in men by a ratio of 1.4: 1). Conclusion: a. High incidence of cervical disc disease in office workers (prolong sitting), housewives and heavy workers (manual worker). b. Lengthy symptom duration was not a negative prognostic marker in our patients. c. Most common abnormal neurological manifestations are a form of radiculomyelopathy, followed by myelopathy. d. Disc space narrowing was the most common abnormality encountered on radiological findings. e. Most affected level was C5-6, followed by C4-5, then C6-7 level and C3-4. f. ACDF with cage plate is an effective treatment for patients with cervical disc disease. g. Patients with MRI show chronic changes of the spinal cord at the affected level (myelomalacia), which signals a poor prognosis of surgery.