Table 5.

Review of the large anterior cervical discectomy series with results and complications

Author and year	Number of cases	Complications	Outcomes	Levels fused	Follow-up (months)
Marotta et al., 2011[22]	167	20% adjacent segment disease	Significant improvement in NDI, VAS score postoperative	Single level	60
Lu et al., 2013[23]	150	No difference in dysphagia in both groups with slight increase in pseudarthrosis in allograft group	Significant decrease in Nurick score compared to preoperatively, however, no difference with addition of r-BMP	Multiple levels up to 4 levels	35
Klingler et al., 2014[24]	109	10% subsidence in follow up	VAS, NDI significant better in follow-up with no significant difference between PEEK cage and PMMA cage	70% single-level, 30% 2-level	29
Li et al., 2017[25]	138	1.5% EDH, hoarseness, dysphagia 7.4%, infection, subsidence 9.8% in cage versus 7.4% in cage+plate	Significant improvement in SF-36, VAS, NDI, JOA score in all group	Up to 4 levels performed	26
Zigler et al., 2016[26]	186	Adjacent segment disease high in 2-level group compared to single level	Significant improvement in NDI, VAS, SF-12 score	Single and 2 levels	60
Tasiou et al., 2017[27]	114	CSF leak, dysphagia, recurrent laryngeal nerve plasy, trachea-esophageal fistula, implant failure	Earlier assessment of perioperative complications – better results	Both single- and multiple-level discs	42.5
Burkhardt et al., 2018[28]	122	Rate of adjacent segment disease is 10%, 8% postoperative dysphagia	89.3% had high rate of radicular pain relief	64% single-level, 33% two-level, 3.3% 3-level	300
Grasso and Landi, 2018[29]	100	2% dysphagia experienced	VAS, improved significantly immediate after surgery and continue till the last follow-up	73% one-level, 27% 2-level	84
Tumialán et al., 2019[30]	135	2.3% transient laryngeal nerve palsy	88% had improvement with return to work	76% single-level, 24% 2-level	48
Mullins et al., 2018[31]	1123	3.6% had complication	VAS and clinical improvement seen significantly in all groups	40% single-level, 34% 2-level, 22% 3-level, 3% 4-level	25
He et al., 2018[32]	104	4% complication in zero profile device and 17% of ACDF	Clinical improvement significant in both groups with no difference between	Multiple levels	24
Muzevic et al., 2018[33]	154	-	80% had clinical improvement	One to multiple levels	24
Yu et al., 2018[34]	247	Greater incidence of subsidence in nonfixed system	VAS and clinical outcomes improvement significant and no different between standalone cage versus fusion with cage and plate	One or two level	24
Butterman 2018[35]	159	10% pseudarthrosis and 21% adjacent segment disease	85%–95% improvement in neurological outcome	Single to 2 levels	120
Lee et al., 2018[36]	167	5 cases pseudarthrosis	VAS of arm pain better in uncinate process removal compared to nonremoval	Single and 2 level	31.4
Yang et al., 2019[37]	134	4% have dysphagia	VAS and NDI reduced postoperatively	2	29.68
Shin, 2019[38]	165	20% adjacent segment disease	VAS and NDI reduced postoperatively at all levels but lesser in 3-level discectomy	Up to 3 levels	31.9
Basques et al., 2019[39]	379	20% adjacent segment disease	VAS and NDI improvement after surgery, but longer duration of radiculopathy poor improvement	45% two-level, 30% single-level, and 25% 3-level	28.2
Shousha et al., 2019[40]	2078	0.9% hematoma, dysphagia, and cage subsidence seen	VAS and NDI improved significantly, however reoperation rate higher in long-segment group	40% single-level, 40% two-level, and 20% multiple-levels	37.8

NDI – Neck disability index; VAS – Visual analog scale; SF-12 – Short Form 12; JOA – Japanese Orthopaedic Scale; ACDF – Anterior cervical discectomy and fusion; PEEK – Polyether ether ketone; PMMA – Polymethyl methacrylate; EDH – Epidural hematoma; r -BMP – Recombinant human bone morphogenetic protein-2