Gökoğlu Abdulkerim, Yiğit Hüseyin, Doğan Kadirhan, Nisari Mehtap, Unur Erdoğan
Institue of Health Sciences, Erciyes University, Kayseri 38030, Türkiye.
Vocational Health School, Cappadocia University, Nevşehir 50400, Türkiye.
J Clin Med. 2025 May 13;14(10):3413. doi: 10.3390/jcm14103413.
Cervical degenerative disc disease (CDD) significantly compromises patients' quality of life through the induction of radiculopathy and myelopathy. This study endeavored to compare the clinical and radiological outcomes of anterior cervical discectomy and fusion (ACDF) in patients presenting with single-, two-, and three-level CDD. A retrospective analysis was conducted on 94 patients who underwent ACDF between December 2018 and December 2023. Patients were categorized into single-level ( = 36), two-level ( = 40), and three-level ( = 18) CDD groups. Preoperative and postoperative radiological (X-ray, MRI) and clinical (Japanese Orthopedic Association [JOA], Visual Analog Scale [VAS]) data were rigorously analyzed. Statistically significant improvements in postoperative JOA and VAS scores were observed across all cohorts. Notably, the three-level CDD group exhibited a significantly lower JOA improvement rate compared to the single-level group ( = 0.040). All groups demonstrated a marked increase in cervical lordosis and disc height postoperatively ( < 0.05). Patients undergoing three-level ACDF presented with lower JOA scores than those undergoing single- or two-level procedures. Logistic regression analysis identified that the preservation of the disc height significantly correlated with a higher likelihood of achieving a greater JOA improvement. ACDF is established as a safe and efficacious surgical intervention for patients with single-, two-, and three-level CDD. The implementation of hybrid prostheses appears to be instrumental in maintaining lordosis in multilevel ACDF. Three-level ACDF is associated with diminished JOA improvement rates compared to single-level ACDF. Further longitudinal, multicenter investigations are warranted to validate these findings.
颈椎间盘退变疾病（CDD）通过诱发神经根病和脊髓病，严重损害患者的生活质量。本研究旨在比较单节段、双节段和三节段CDD患者行颈椎前路椎间盘切除融合术（ACDF）后的临床和影像学结果。对2018年12月至2023年12月期间接受ACDF的94例患者进行了回顾性分析。患者被分为单节段（n = 36）、双节段（n = 40）和三节段（n = 18）CDD组。对术前和术后的影像学（X线、MRI）和临床（日本骨科协会[JOA]、视觉模拟评分[VAS]）数据进行了严格分析。所有队列术后JOA和VAS评分均有统计学意义的改善。值得注意的是，三节段CDD组的JOA改善率明显低于单节段组（P = 0.040）。所有组术后颈椎前凸和椎间盘高度均显著增加（P < 0.05）。接受三节段ACDF的患者JOA评分低于接受单节段或双节段手术的患者。逻辑回归分析表明，椎间盘高度的保留与获得更大JOA改善的可能性显著相关。ACDF被确立为单节段、双节段和三节段CDD患者安全有效的手术干预措施。混合假体的应用似乎有助于维持多节段ACDF中的前凸。与单节段ACDF相比，三节段ACDF的JOA改善率较低。需要进一步的纵向、多中心研究来验证这些发现。
