A Single Level Anterior Cervical Discectomy and Fusion, it’s Impact on Disc Height of Surgical and Adjacent Cervical Levels

Background: Anterior cervical discectomy and fusion (ACDF) is the gold standard treatment for cervical disc her-niation after failure of conservative non-surgical treatment measures, Adjacent segments degenerative changes are a well-known sequel after ACDF. Several theories were discussed to explain this phenomenon. Aim of Study: The aim of the study was to study the adja-cent levels both above and below, as well as the affected discs for height changes during one year follow-up period. Patients and Method: This is a prospective clinical study conducted on 64 patients who underwent anterior cervical discectomy for one level in the Neurosurgery Department of Cairo University hospitals, in the period from Nov. 2018 till May 2023 cases had a follow-up period ranging from 6 months to 24 months (mean 15 months). Our cases included patients with both cervical radiculopathy and cervical myelopathy syn-dromes caused by disc disease. The heights of the affected disc space and the two adjacent levels (the next cranial and caudal ones) were assessed preoperatively by measuring a ratio be-tween the disc height and the vertebral body below. Results: Sixty-four patients with single level cervical disc pathology were evaluated during the period assigned for data collection from Nov. 2019 till May 2023. Data collected from these cases was statistically analyzed. 41 males and 23 females (M/F ratio 1.78). The pre-operative ratio between the affected discs heights and the vertebrae below ranged from 0.24 to 0.34, with a mean ratio of 0.29. These ratios for the adjacent levels ranged from 0.35 to 0.40, with a mean of 0.37. these ratios were recalculated immediately after surgery and along follow-up. Conclusion: Decrease in disc height is one of the earliest of these changes. It’s encountered it almost all cases after surgery by a short period. However, these radiographic changes haven’t shown any clinical implication in the short follow-up period. A longer follow-up period is needed.