Chronological Change of Lumbar Symptoms After Anterior Cervical Discectomy and Fusion for Degenerative Cervical Radiculopathy at a Single Level

Introduction: This exploratory retrospective study aimed to analyze the chronological impact on lumbar symptoms after anterior cervical discectomy and fusion (ACDF) for degenerative cervical radiculopathy (DCR).Methods: Patients with DCR who underwent ACDF for a single level between January 2017 and September 2022 were included.The following scores from these questionnaires at postoperative year 1 were statistically compared: Japanese Orthopaedic Association (JOA) score, Back Pain Evaluation Questionnaire (BPEQ), Cervical Myelopathy Evaluation Questionnaire (CMEQ), Neck Disability Index (NDI), Oswestry Disability Index (ODI), and visual analog scale (VAS).Although statistical significance was defined as a p-value of <0.05, we did not interpret adjusted p-values confirmatively because this study is an exploratory analysis.Results: A total of 29 patients (15 men and 14 women) with an average age of 60.8 years were enrolled in this exploratory study.Preoperative and postoperative cervical total JOA scores were 14.95±1.26and 16.31±0.80,respectively.Preoperative CMEQ scores for cervical spine, upper extremities, lower extremities, bladder, and quality of life (QOL) were 64.66±22.36,87.86±14.17,88.79±12.26,87.86±14.22,and 50.72±13.29,respectively.Postoperatively, those variables were 86.90±14.85,95.10±8.08,91.07±14.19,89.79±14.55,and 59.38±15.12,respectively.Preoperative VAS scores for neck and shoulder, chest, upper extremities, and trunk/lower extremities were 64.28±26.72,6.55±15.15,60.86±30.18,and 12.93±20.53,respectively.Postoperatively, those scores were 45.86±33.75,6.41±17.15,41.55±35.70,and 22.33±30.03,respectively.Preoperative and postoperative NDI scores were 27.62±15.19and 17.00±12.07,respectively.Significant improvements were identified in these variables.However, we did not identify any significant postoperative improvement in JOA III, CMEQ (lower extremities and bladder), VAS (chest and trunk/lower extremities), and lumbar questionnaire scores.A sub-analysis of patients with preoperative VAS (lumbar spine) of 20.00 or more, or ODI of 21.00% or more, did not show significant postoperative improvement in lumbar questionnaire scores, either.Conclusion: The impact of ACDF at a single level for patients with DCR could be limited for preoperative lumbar symptoms.