1. SURGICAL TREATMENT OF CERVICAL DEGENERATIVE DISC DISEASE WITH MYELORADICULOPATHY: TWO-LEVEL ANTERIOR DISCECTOMY VERSUS ONE LEVEL ANTERIOR CORPECTOMY Istanbul Spine Center Florence Nightingale Hospital Istanbul-TURKEY Ahmet ALANAY, MD Kursat GANIYUSUFOGLU, MD Selhan KARADERELER, MD Mehmet AYDOGAN, MD Cagatay OZTURK, MD Azmi HAMZAOGLU, MD

2. PURPOSE The aim of this retrospective study is to compare two fusion techniques with reference to perioperative and radiological parameters and clinical outcomes. MATERIALS & METHODS 74 patients having surgery due to 2-level cervical spondylotic myeloradiculopathy Surgery; ACDF (two contiguous levels) ACCF (single level including 2 disc spaces)

3. MATERIALS & METHODS The perioperative parameters Hospitalization Blood loss Operation times Complications The radiologic parameters Cervical lordosis Fusion rate The clinical parameters Visual Analog Scale [VAS] scores of neck and arm pain

4. RESULTS ACDFACCF # of patients 4727 Mean age (y) 53.755.3 Male to Female ratio 21/2611/16 Mean F/U (m) 48.451.2 Perioperative parametersACDFACCFp Hospitalization (day)5.25.4>0.05 Blood loss (cc)283342>0.05 Operation time (minutes)180210>0.05 Complications*4/472/27>0.05 *ACDF: dura laceration in 1, hoarseness in 3 patients. *ACCF: dura laceration in 1, incomplete transient C5 palsy in 1 patient.

5. RESULTS Clinical OutcomesACDFACCFp Preop neck VAS5.65.4>0.05 Postop neck VAS2.82.5>0.05 Preop arm VAS6.25.9>0.05 Postop arm VAS2.72.6>0.05 Radiological parameters ACDFACCFp Fusion rate (%)100 >0.05 Preop cervical lordosis (degrees) 18.317.4>0.05 Postop cervical lordosis (degrees) 24.421.60.045

6. MT, 47 y, M

7. MT, 49 y, M

8. CONCLUSION Surgical management of 2-level cervical degenerative disc disease with myeloradiculopathy by ACDF or ACCF showed no significant differences in terms of clinical symptom improvement and fusion rates.

9. CONCLUSION Although statistically insignificant, blood loss and operation times were lower in ACDF group. In addition, ACCF provided less improvement in cervical lordosis.

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