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Outcome of Anterior Cervical Discectomy and Fusion as Perceived by Patients Treated for Dominant Axial–Mechanical Cervical Spine Pain

Garvey, Timothy A. MD; Transfeldt, Ensor E. MD; Malcolm, James R. MD; Kos, Paul MS

Cervical Spine

Study Design. An extensive outcome questionnaire using a visual analog scale, the North American Spine Society Satisfaction Questionnaire, a Modified Roland and Morris disability index, and a modified Oswestry Disability Index was used to assess the outcome of anterior cervical discectomy and fusion for those with neck pain.

Objective. To document the clinical outcome for 87 patients who underwent anterior cervical discectomy and fusion for the primary indication of neck pain, as assessed after an average follow-up period of 4.4 years.

Summary of Background Data. Clinical outcome studies of anterior cervical discectomy and fusion with validated patient-perceived outcome measurements are few.

Methods. From the authors’ database, 87 patients were identified who had undergone an anterior cervical discectomy and fusion for primary indication of dominant neck pain, and who had completed an extensive outcome questionnaire regarding pain and self-function at a mean 4.4-year follow-up assessment.

Results. This study documents a self-perceived satisfactory outcome rate of 82%. Patients reported on improvement of pain using visual analog scales, on function using modified Oswestry and modified Roland–Morris disability indexes, and on satisfaction using the North American Spine Society outcome tool. On an assessment 4.4 years on the average after the surgery, 82% of the patients (71/87) self-perceived their outcome to be good, very good, or excellent. Pain improvement was reported by 93% of the patients (81/87), whose average visual analog rating changed from 8.4 before surgery to 3.8 after surgery. The self-rated functional status improved approximately 50% on both the Oswestry and the modified Roland–Morris disability indexes.

Conclusions. Properly selected patients who present with a primary indication of chronic neck pain report a high percentage of change in their self-perceived level of pain and function when treated with anterior cervical discectomy and fusion. Patients’ self-expressed improvement with surgical management, as compared with their preoperative dissatisfaction because of their neck condition, documents that this surgical treatment is a reasonable option.

From the Twin Cities Spine Center and the University of Minnesota, Minneapolis, Minnesota.

Acknowledgment date: January 3, 2001.

First revision date: June 1, 2001.

Acceptance date: November 19, 2001.

Address reprint requests to

Timothy A. Garvey, MD

913 East 26th Street

Suite 600

Minneapolis, MN 55404

E-mail: informat@tcspine.com

Device status/drug statement: The submitted manuscript does not contain information about medical devices or drugs.

Conflict of interest: No funds were received in support of this work. No benefits in any form have been or will be received from a commercial party related directly or indirectly to the subject of this manuscript.

© 2002 Lippincott Williams & Wilkins, Inc.