Prospective Observational Outcomes after Anterior Cervical Discectomy and Fusion

To assess pain relief, neurological outcome, radiographic fusion, and perioperative complications after anterior cervical discectomy and fusion (ACDF) at 12 months.

An observational study. Place and Duration of the Study: Department of Neurosurgery, MTI-Mardan Medical Complex, Mardan, Pakistan, from January 2022 to June 2024.

ACDF was performed in adult patients who had symptomatic cervical disc disease, which was MRI-confirmed and not responding to conservative treatment. The Visual Analogue Scale (VAS) was used to examine neck and arm pain, and the modified Japanese Orthopaedic Association (mJOA) to evaluate neurological functioning. Radiographic fusion was assessed at 12 months by dynamic flexion/extension radiographs and CT in equivocal cases. Preoperative and postoperative outcomes were compared using a paired sample t-test, and exploratory subgroup analyses were performed based on presenting diagnosis and implant type.

A total of 200 patients were included (mean age 47.1 years; 71.5% male). Single-level surgery was performed in 93.5% of patients. At 12 months, radiographic fusion was achieved in 90.5% of patients. There was significant improvement in mean neck pain, arm pain, and mJOA scores after surgery (p <0.001). The diagnostic groups had broadly similar clinical outcomes. The total complication rate was 19.5%, with transient dysphagia being the most frequent (14.5%).

ACDF was associated with substantial pain relief, neurological recovery, and high fusion rates at 12 months with acceptable complication rates.

ACDF, Cervical radiculopathy, Cervical myelopathy, Fusion, Dysphagia.