Comparison of clinical outcomes between sequestered cervical disc herniation and non- sequestered cervical disc herniation after anterior cervical decompression and fusion: a cohort study

Abstract

Abstract Background The advantages of anterior cervical decompression and fusion (ACDF) were well published, while research on postoperative results in different subtypes of cervical disc herniation (CDH) still remain blank. This study aimed to explore the operational effect between sequestration and other types in CDH. Methods This retrospective cohort study enrolled 108 patients treated with ACDF in our hospital. The participants were divided into two groups according to the existence of sequestered disc. The Visual analog scale(VAS) score, the Japanese Orthopedics Association(JOA)score and the Neck disability index(NDI) score were used to evaluate postoperative outcome. Results Significant improvements were observed in both groups at every viewpoint(P < 0.001). The mean JOA was 15.04 ± 1.26 in sequestered disc group and was 14.45 ± 1.43 in non-sequestered disc group two months after operation (P = 0.026 < 0.05). The improvement of JOA in two months after ACDF showed statistical difference:46.58%±39.17% in sequestered disc group and 33.39%±28.82% in non-sequestered disc group(p = 0.047 < 0.05).32 patients in sequestered disc group (64%) and 19 patients in non-sequestered disc group (32.76%) were presented with high signal intensity of spinal cord on preoperative cervical T2-weighted MRI, with statistical difference (P < 0.001). Conclusions Patients with sequestered cervical disc seemed to have a higher degree of symptom improvement two months after ACDF. CDH with sequestered disc appears to be more likely to cause high signal intensity changes in the compressed cervical spine on T2-weighted MRI. We prefer early positive surgery in patients with sequestered cervical disc from the clinical point of view.