ArticleActa neurochirurgica2024
Outcomes of non-contiguous two-level anterior cervical discectomy and fusion in patients with degenerative cervical myelopathy: a retrospective study.
Article in Acta neurochirurgica, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.
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Who cites it
5 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Comparison of skip-level ACDF vs. contiguous ACDF in the treatment of skip-level cervical degenerative disease: a systematic review and meta-analysis.Frontiers in surgery · 2026Pooled it
- Biomechanical effects of different intervertebral height reconstructions on the intermediate segment in skip-level ACDF for discontinuous cervical spondylosis: a finite element analysis.BMC musculoskeletal disorders · 2026Article
- Dynamic Cervical Myelopathy Misleading on Neutral Imaging: The Role of Flexion-Extension MRI.Journal of clinical medicine · 2026Article
- Reply to the Letter to the Editor of M. Zhang, et al. concerning "Surgical strategies and outcomes in degenerative myelopathy at the cervico-thoracic junction: a multicenter retrospective analysis" by Umana GE, et al. (Eur Spine J [2025]: doi:10.1007/s00586-025-09139-7).European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2025Article
- Contiguous versus skip discectomy and fusion in cervical disc herniation: Do we need to fuse the normal intermediate segment?Journal of craniovertebral junction & spineArticle
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Authors and funding
10 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundNon-contiguous two-level Anterior Cervical Discectomy and Fusion (ACDF) may be a viable option for patients with degenerative cervical myelopathy and imaging-evident spine and radicular compression at two non-contiguous cervical levels. The risk of hastening degeneration and triggering Adjacent Segment Disease at the spine levels located between the fused levels is a putative adverse event, which was assessed in a few studies. The aim of this study is to investigate the clinical outcomes of patients undergoing non-contiguous two levels ACDF and to assess biomechanical modifications at non-fused segments.
methodWe retrospectively reviewed all patients with noncontiguous two-level spine and radicular compression, who underwent simultaneous noncontiguous two-level ACDF at our center. We analyzed clinical and radiological outcomes and investigated the rate of adjacent segment disease. Radiographic parameters were calculated on pre- and postoperative images.
resultsThirty-two patients underwent simultaneous noncontiguous two-level ACDF for cervical myelo-radiculopathy between 2015 and 2021 and were followed up for a mean period of 43.3 months. For all patients, the mJOA score significantly improved from 14.57 ± 2.3 to 16.5 ± 2.1 (p<0.01) and the NDI score significantly decreased from 21.45 ± 4.3 to 12.8 ± 2.3 (p<0.01) postoperatively. Cervical lordosis increased after surgery (from 9.65° ±9.47 to 15.12° ± 6.09); intermediate disc height decreased (5.68 mm ± 0.57 to 5.27 mm ±0.98); the ROMs of intermediate (from 12.45 ± 2.33 to 14.77 ± 1.98), cranial (from 14.63 ± 1.59 to 15.71 ± 1.02), and caudal (from 11.58 ± 2.32 to 13.33 ± 2.67) segments slightly increased. During follow-up assessment, in one patient the myelopathy worsened due to spine compression at the intermediate level.
conclusionsSimultaneous and non-contiguous two-level ACDF is a safe and effective procedure. The occurrence of postoperative adjacent and intermediate segment disease is rare.
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