If you have a new Retina display or are using the latest creative. These findings suggest a significant increase of perioperative morbidity and worsened outcomes for patients who undergo 4- versus 3-level ACDF.ģ-level 4-level ACDF ACDF = anterior cervical discectomy and fusion ASD = adjacent-segment disease anterior cervical discectomy and fusion cervical spine fusion outcomes. Suitcase Fusion 6 is a mature product that’s keeping pace with new operating systems, applications, and the online community. Additionally, a smaller proportion of patients achieved a good/excellent outcome in the 4-level group than in the 3-level group. Pseudarthrosis and deep wound infection rates were also higher in the 4-level group, although this did not reach statistical significance. CONCLUSIONS In this study, patients who underwent 4-level ACDF had significantly higher rates of dysphagia, postoperative neck pain, and postoperative narcotic usage when compared with patients who underwent 3-level ACDF. Outcomes based on Odom's criteria were also different between cohorts (p = 0.044), with a significantly lower proportion of patients in the 4-level ACDF group experiencing an excellent/good outcome. At last follow-up, a significantly higher proportion of patients in the 4-level group continued to have axial neck pain (53.8%) than in the 3-level group (31% p = 0.039) the daily oral morphine equivalent dose was significantly higher in the 4-level group (143 ± 97 mg/day) than in the 3-level group (25 ± 10 mg/day p = 0.030). The fusion rate was 84.6% after 4-level ACDF and 94.4% after 3-level ACDF (p = 0.122). Postoperatively, 31% of patients in the 4-level group complained of dysphagia, compared with 12.7% in the 3-level group (p = 0.038). There was 1 case (3.9%) of deep wound infection in the 4-level group and 1 case in the 3-level group (1.4% p = 0.454). RESULTS Seventy-one patients who underwent 3-level ACDF and 26 patients who underwent 4-level ACDF were identified and followed for an average of 7.6 ± 4.2 years. Outcome measures included perioperative complication rates, fusion rates, need for revision surgery, Nurick Scores, Odom's criteria, symptom resolution, neck visual analog scale (VAS) pain score, and persistent narcotics usage. Patients who underwent first-time 3- or 4-level ACDF were included patients with previous cervical spine surgery, those undergoing anterior/posterior approaches, and those with corpectomy were excluded.
METHODS A retrospective review of all adult neurosurgical patients undergoing elective ACDF for degenerative disease at a single institution between 19 was performed.
OBJECTIVE The purpose of this study was to report the long-term clinical outcomes following 3- and 4-level anterior cervical discectomy and fusion (ACDF).