Predictive Factors For The Outcome of Anterior Cervical Discectomy and Fusion Surgery for Myelopathy Cervical Disc Herniation: A Single-Center Study in Vietnam

Abstract

Abstract Background: Cervical disc herniation is a prevalent condition contributing to cervical myelopathy. This technique has gained popularity in various centers around the globe. However, there is a lack of data on the actual surgical outcomes for this specific patient group in Vietnam. This study aims to investigate predictive factors for the surgical outcomes and postoperative complications associated with anterior cervical discectomy and fusion surgery in patients presenting with myelopathy due to cervical disc herniation. Methods: A retrospective analysis was conducted on 74 patients who underwent ACDF surgery for myelopathy resulting from cervical disc herniation at Nguyen Tri Phuong Hospital, from January 2019 to September 2021. Data encompassing demographics, clinical and radiological characteristics, surgical outcomes, and complications were meticulously collected. Results: Among the 74 patients, 53 were men and 21 were women, ranging from 29 to 79 years. Herniation occurred at one level in 45.9% of cases, at two levels in 47.3%, and at three levels in 6.8%. Neurological improvement was assessed during a 12-month follow-up. Patients were assessed with VAS and NDI preprocedural and postprocedural for 1-month, 6-month, and 12-month follow-ups. There was a significant improvement in postprocedural VAS and NDI scores (p<0.001). The mean preoperative mJOA score was 11.1, increasing to 14.8 postoperatively. A recovery rate exceeding 75% was noted in 21.6% of patients. Dysphagia was the most common complication (8.1%). Conclusions: Anterior cervical discectomy and fusion surgery emerge as an effective and secure treatment modality for myelopathy stemming from cervical disc herniation.