Study of Functional Outcome of Anterior Cervical Decompression and Fusion Using Tricortical Iliac Bone Graft for Degenerative Cervical Spondylotic Myelopathy with Modified Japanese Orthopedic Association Score
|Ayush Sharma1*, Mayur Dhake1, Vijay Singh1, Natraj B1, Rajat Mahajan2, Prashant Kamble3, Pritish Khardikar1, Tarun Chabra4, Akshay Jadhav1 and Darshan Devani1|
|1Department of Orthopedic and Spine Surgeries, Dr BR Ambedker Central Railway Hospital, Mumbai, India|
|2Indian Spinal Injuries Center, New Delhi, India|
|3King Edward Memorial Hospital and Seth G S Medical Collage, Mumbai, India|
|4Ganga Hospital, Coimbatore, India|
|Corresponding Author :||Ayush Sharma
Department of Orthopedic and Spine Surgeries
Dr BR Ambedker Central Railway Hospital
Byculla East, Mumbai, India
E-mail: [email protected]
|Received August 13, 2015; Accepted September 05, 2015; Published September 07, 2015|
|Citation: Sharma A, Dhake M, Singh V, Natraj B, Mahajan R, et al. (2015) Study of Functional Outcome of Anterior Cervical Decompression and Fusion Using Tricortical Iliac Bone Graft for Degenerative Cervical Spondylotic Myelopathy with Modified Japanese Orthopedic Association Score. J Spine 4:255.doi:10.4172/2165- 7939.1000255|
|Copyright: © 2015 Sharma A, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.|
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Objective: To determine functional outcome of anterior cervical decompression and fusion using tricortical iliac bone graft (ACDF) for degenerative cervical spondylotic myelopathy with modified Japanese orthopedic association score (MJOA).
Materials and Methods: 60 diagnosed cases of one and two levels cervical myelopathy were prospectively analyzed preoperatively and at 3 months, 6 months, 1 year using MJOA.
Results: 46 patients underwent Single level ACDF with C5-C6 the commonest level to be affected. The correlation between Duration of Symptoms to Preoperative and postoperative MJOA was statistically significant. We noted statistically significant improvement in symptoms of axial neck pain, radicular arm pain, clumsy hand, and gait disturbances post operatively at one year. Statically significant difference was noted while comparison MJOA of Preoperative to 6 months and 1 year, and 3 months to 6 months and 1 year. Statistically significant difference in blood loss and anesthesia time for one level fusion compared with two level fusions was also noted. The fusion rate for single level ACDF was 95.65% compared to 71.42% for two levels.
Conclusion: Functional outcomes in operated patients at 1-year follow up are better if ACDF surgery is done early. Symptoms of axial neck pain; radicular arm pain, clumsy hand and gait disturbances show significant improvement at one year follow up. While bladder and bowel involvement showed the least recovery. Significant improvement in function occurs postoperatively between 3 and 6 months, and then it plateaus from 6 months to 1 year. Fusion rates for single level ACDF are better than two levels ACDF.