Treatment ผลลัพธ์ทางการรักษาหลังการผ่าตัดหมอนรองกระดูกคอ (ACDF) ในผู้ป่วยที่เข้า รับการรักษาโรงพยาบาลร้อยเอ็ด: การวิเคราะห์ 3 เดือนหลังผ่าตัด

Thanakorn Khlangsaeng

doi:10.1016/hscr.v40i2.277180

Authors

Thanakorn Khlangsaeng Department of Sugery, Roi Et Hospital

DOI:

https://doi.org/10.1016/hscr.v40i2.277180

Keywords:

Anterior cervical discectomy and fusion, Recovery rate, Treatment outcomes, Neck Disability Index

Abstract

Objective: To evaluate treatment outcomes and identify factors associated with the modified Japanese Orthopaedic Association (mJOA) Recovery Rate in patients who underwent anterior cervical discectomy and fusion (ACDF) within a 3-month postoperative period.
Methods: Medical records of 61 patients who underwent ACDF between January 2013 and April 2025 were reviewed. Data collected included demographic information, preoperative and postoperative clinical characteristics, and 3-month postoperative outcomes. Descriptive statistics, univariate analysis, and multivariate logistic regression were performed, with statistical significance set at p < 0.05.
Results: Among the 61 patients, most were male (70.49%) with a mean age of 60.07 years (SD = 8.07). Prior to surgery, the majority had moderate mJOA scores (77.05%), with C5–C6–C7 being the most common surgical level (26.23%). At 3 months postoperatively, most patients improved to mild mJOA scores (65.57%). Neck Disability Index (NDI) was mostly in the mild category (61.40%). Patient satisfaction with outcomes was reported in 67.21%, and 73.77% were able to return to work. Factors significantly associated with a recovery rate < 50% included body mass index (BMI) of 25–29.90 kg/m², preoperative mJOA score < 11, symptom duration longer than 76–100 weeks, and multilevel (≥3 levels) fusion.
Conclusions: Most patients demonstrated favorable clinical outcomes within 3 months after ACDF, with improvement in mJOA score to the mild category and NDI within the mild range. The majority were satisfied with the surgical outcomes and were able to return to work. However, poorer recovery rate was observed in patients with higher BMI, lower preoperative mJOA scores, longer symptom duration, and multilevel fusion. Early surgical intervention, especially in patients with low mJOA scores, along with weight management and long-term follow-up, is recommended. Further studies are warranted to identify additional prognostic factors for optimizing patient care.

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