Outcome of Anterior Cervical Discectomy and Fusion in Symptomatic Cervical Disc Herniation with Autologous Iliac Bone Graft and Metallic Implant

Background: Anterior cervical discectomy and fusion (ACDF) is a challenging surgical procedure where appropriate patient selection is very important for operation outcome and choice of surgical procedure. The first-line treatment strategy for managing cervical disc herniation is conservative. In some cases, surgery is indicated either due to signs and symptoms of severe and progressive neurological deficits, or failure of proper conservative treatment. Treatment of cervical disc herniation using ACDF has been successfully reported in the literature. Objectives: The aim of this study is to determine the outcome of ACDF in the treatment of symptomatic cervical disc herniation. Methods: It is a retrospective study conducted in Dhaka Medical College Hospital (DMCH) and other private hospitals from January 2013 to December 2022. We evaluated 28 patients who had undergone ACDF for cervical disc herniation in 35 levels. Fusion was attained with autologous iliac bone graft with additional anterior plating or cages. Radicular pain, neck pain and patient satisfaction with the treatment were scored using the visual analogue scale (VAS), ODI and Odom’s criteria. Results: A total of 28 patients fulfilled the inclusion criteria. Out of these, 21(75%) patients were male. The age range was from 21 to 65 with a mean age of 47.45 years. 10 patients (35.71%) had disc herniation at C5/6 level and 7(25%) patients had at C6/7 level. Regarding clinical assessment, the ODI percentage has decreased and VAS for neck and radicular pain also showed a significant reduction. Odom’s criteria was applied to determine the outcome of the procedure. Excellent results were noted in 20 (71.42%) patients. 5 (17.85%) patients had good results. 3 patients (10.71%) had fair and no patient had a poor outcome. Conclusion: ACDF is a successful surgical technique for the management of cervical disc herniation among Bangladeshi people. J Dhaka Med Coll. 2024; 33(2) : 63-68