Our Summary

This research paper looks at the different ways to treat a condition called multilevel cervical degenerative disc disease (CDDD), which is a problem with the discs in the neck. The researchers looked at three types of surgery: anterior cervical discectomy and fusion (ACDF), cervical disc arthroplasty (CDA), and a mix of the two called hybrid surgery (HS). They wanted to see how patients did after each type of surgery, so they analyzed a bunch of studies that had been published before December 2018.

They found eight studies that met their criteria, with a total of 424 patients. They found that after hybrid surgery, patients had more movement in their neck than those who had ACDF. They also found that the level of movement in the joints above and below the area of the surgery was less after hybrid surgery than after ACDF. Patients who had hybrid surgery were able to go back to work quicker than those who had ACDF or CDA.

There was no real difference in how well patients did after CDA compared to hybrid surgery. There was also no significant difference in how long the operations took, how much blood was lost during the operations, or what complications patients had after the operations.

However, the researchers caution that the number of studies they looked at was small, and there were a lot of differences between the studies. The quality of the evidence they found was also very low. They call for more large, high-quality studies to be done, so that doctors can have solid evidence when deciding which type of surgery to recommend.

FAQs

  1. What are the three types of surgery used to treat multilevel cervical degenerative disc disease discussed in this research paper?
  2. How does the patient’s recovery and mobility after hybrid surgery compare to anterior cervical discectomy and fusion and cervical disc arthroplasty?
  3. What are the limitations of this research on the effectiveness of different surgeries for multilevel cervical degenerative disc disease?

Doctor’s Tip

One helpful tip a doctor might tell a patient about discectomy is to follow post-operative instructions carefully, including recommendations for physical activity, lifting restrictions, and wound care. It is important to attend all follow-up appointments and communicate any concerns or changes in symptoms to your healthcare provider. Additionally, maintaining a healthy lifestyle with proper nutrition and regular exercise can help support the healing process and prevent future complications.

Suitable For

Patients who are typically recommended for discectomy are those who have not responded well to conservative treatments such as physical therapy, medications, and injections. Specifically, patients with symptoms of multilevel cervical degenerative disc disease (CDDD) such as neck pain, arm pain, weakness, and numbness may be candidates for discectomy surgery. Additionally, patients with severe disc herniation or spinal cord compression may also be recommended for discectomy.

In the case of multilevel CDDD, patients may be recommended for anterior cervical discectomy and fusion (ACDF), cervical disc arthroplasty (CDA), or hybrid surgery (HS) depending on their specific condition and symptoms. The decision on which type of surgery to recommend is typically made by a spine surgeon after a thorough evaluation of the patient’s condition and medical history.

Overall, patients who are experiencing significant pain, neurological symptoms, and functional impairment due to multilevel CDDD may be recommended for discectomy surgery as a way to alleviate their symptoms and improve their quality of life.

Timeline

Before the discectomy surgery, a patient typically experiences symptoms of multilevel cervical degenerative disc disease, such as neck pain, arm pain, weakness, and numbness. They may have undergone conservative treatments like physical therapy, medications, and injections, but these may not have provided relief.

After the discectomy surgery, the patient will go through a recovery period that includes pain management, physical therapy, and restrictions on activities. Over time, the patient should experience a reduction in symptoms and an improvement in neck and arm function. Ultimately, the goal of the surgery is to alleviate pain and improve the patient’s quality of life.

What to Ask Your Doctor

Some questions a patient should ask their doctor about discectomy include:

  1. What are the potential risks and complications associated with the procedure?
  2. How long is the recovery period after the surgery?
  3. What are the expected outcomes in terms of pain relief and improved mobility?
  4. Are there any alternative treatment options to consider?
  5. What is the success rate of the specific type of discectomy being recommended?
  6. How experienced is the surgeon in performing this type of surgery?
  7. Will physical therapy be necessary after the surgery?
  8. What type of follow-up care will be required?
  9. Are there any long-term implications or risks to consider?
  10. How soon can I expect to resume normal activities after the surgery?

Reference

Authors: Hollyer MA, Gill EC, Ayis S, Demetriades AK. Journal: Acta Neurochir (Wien). 2020 Feb;162(2):289-303. doi: 10.1007/s00701-019-04129-3. Epub 2019 Dec 17. PMID: 31848789