Our Summary
This research paper compares two surgical methods for treating a condition known as combined cervical myeloradiculopathy (CMR), which is a disorder affecting the neck and spinal cord. The two treatments are known as Anterior Cervical Discectomy and Fusion (ACDF) and Laminoplasty combined with Foraminotomy (LPF).
The study followed 84 patients (42 for each treatment) who had either the ACDF or LPF surgery and were monitored for at least 2 years. The researchers measured several outcomes, including the curve of the neck (lordosis), the vertical alignment of the neck, and the range of motion. They also asked patients to rate their neck and arm pain and assessed their neck disability and overall recovery.
The results showed that both surgeries led to a decrease in the curve of the neck and the range of motion. However, patients who had the ACDF surgery reported a significant improvement in neck pain and disability, while this was not the case for those who had the LPF surgery. Six months after surgery, patients who had LPF surgery reported more neck pain and disability than those who had ACDF, but this difference wasn’t significant two years after surgery. Both surgeries led to significant improvement in arm pain and overall recovery and there wasn’t a significant difference in these improvements between the two surgeries.
In conclusion, while both surgeries had similar outcomes for arm pain and overall recovery, ACDF led to more immediate improvement in neck pain. In addition, LPF surgery led to a greater post-surgery loss of the neck curve, while ACDF led to a greater decrease in the neck’s range of motion. These findings should be taken into account when choosing the surgical method for treating patients with CMR.
FAQs
- What were the two surgical methods compared in the research for treating combined cervical myeloradiculopathy (CMR)?
- What were the results of the study comparing Anterior Cervical Discectomy and Fusion (ACDF) and Laminoplasty combined with Foraminotomy (LPF) in terms of neck pain, disability, and overall recovery?
- How did the two surgical methods impact the curve of the neck and the range of motion post-surgery?
Doctor’s Tip
A doctor might tell a patient considering discectomy surgery to carefully weigh the potential benefits and drawbacks of different surgical methods, such as ACDF and LPF, based on their individual condition and desired outcomes. It’s important to discuss these options with your doctor and consider factors such as pain relief, neck function, recovery time, and long-term outcomes before making a decision. Additionally, following post-operative instructions and attending physical therapy as recommended can help optimize the success of the surgery and improve recovery.
Suitable For
Patients with combined cervical myeloradiculopathy (CMR) who are experiencing neck and arm pain, neck disability, and limited range of motion are typically recommended for discectomy surgery. These patients may have tried non-surgical treatments such as physical therapy, medications, and injections without success, and their symptoms may be affecting their daily activities and quality of life. Discectomy surgery, such as Anterior Cervical Discectomy and Fusion (ACDF) or Laminoplasty combined with Foraminotomy (LPF), may be recommended to alleviate nerve compression and restore function in the affected area.
Timeline
Before the discectomy surgery, the patient will likely have been experiencing symptoms such as neck pain, arm pain, weakness, numbness, and tingling. They may have tried conservative treatments such as physical therapy, medications, and injections without success. The patient will have undergone diagnostic tests such as X-rays, MRI, and possibly nerve conduction studies to confirm the diagnosis and determine the extent of the disc herniation.
After the discectomy surgery, the patient will typically stay in the hospital for a few days for observation and pain management. They will be encouraged to gradually start moving and walking to prevent complications such as blood clots. Physical therapy may be recommended to help regain strength and mobility in the neck and arms. The patient will need to follow post-operative instructions such as avoiding heavy lifting, bending, and twisting for a certain period of time.
In the weeks and months following the surgery, the patient will gradually start to notice improvement in their symptoms. The neck and arm pain should decrease, and the weakness and numbness should improve. Physical therapy will help to further strengthen the muscles in the neck and arms and improve range of motion. It may take several months for the patient to fully recover and return to their normal activities.
Overall, the discectomy surgery should provide significant relief from the symptoms of CMR and improve the patient’s quality of life. Follow-up appointments with the surgeon will be scheduled to monitor progress and address any concerns or complications that may arise.
What to Ask Your Doctor
Some questions a patient should ask their doctor about discectomy include:
- What is the specific reason for recommending a discectomy in my case?
- What are the potential risks and complications associated with the discectomy procedure?
- How long is the recovery period expected to be after the discectomy surgery?
- What are the expected outcomes in terms of pain relief and functional improvement after the discectomy?
- Are there any alternative treatment options to discectomy that I should consider?
- How many discectomy procedures have you performed, and what is your success rate?
- Will I need physical therapy or rehabilitation after the discectomy surgery?
- What type of anesthesia will be used during the discectomy procedure?
- How long will I need to stay in the hospital after the discectomy surgery?
- What is the long-term prognosis for my condition after undergoing a discectomy?
Reference
Authors: Park S, Jeong G, Hwang CJ, Cho JH, Lee DH. Journal: Spine J. 2024 Dec;24(12):2253-2263. doi: 10.1016/j.spinee.2024.08.027. Epub 2024 Sep 11. PMID: 39271021