A Retrospective Analysis of Patient Perceived Outcomes in Patients 55 Years and Older Undergoing Anterior Cervical Discectomy and Fusion

J Spinal Disord Tech 2010;23:157–161

Study Design/Setting: Retrospective review of clinical outcomes after anterior cervical discectomy and fusion (ACDF) surgery with allograft and plating in patients over 55 years of age.

Objective: To evaluate the results of ACDF surgery in patients aged 55 years and older.

Summary of Background Data: ACDF surgery has been a standard treatment for cervical degenerative and herniated disc disease for many years. Previous assessments of efficacy have used patient perceived outcome measures including the Neck Disability Index (NDI) and the Short Form 36 Question Health Questionnaire (SF-36). Patient perceived outcome after ACDF surgery in an age specific cohort (55 y and older) has not been documented previously.

Methods: Fifty-two consecutive patients over 55 years of age who underwent 1 to 3 level ACDF with allograft and plating were identified. Patient perceived outcome questionnaires (NDI and SF-36) were available for 44 patients. There were 28 females and 16 males. Mean age at time of surgery was 61.8 years. Average length of follow-up was 25.2 months (12 to 54 mo).

Results: All but one patient demonstrated radiographic healing of the fusion site at the time of their last follow-up. The mean improvement of these 10 groups (total NDI score) was statistically significant (difference = 9.47, t=5.6390, P=1.5198E-06). There was a statistically significant decrease in disability in 7 of the 8 SF-36 categories as well. The mean of the 8 SF-36 categories (total SF-36) improved significantly (improvement=11.92, t= 3.6857, P=0.0007).

Conclusions: On the basis of our statistically significant improvement in NDI and SF-36 scores, as a measure of patient perceived outcome after ACDF surgery, outcomes after ACDF surgery in patients over 55 years of age are not significantly different than those of a younger patient population