Comparison of anterior cervical decompression fusion versus anterior cervical corpectomy with paramesh in central cord syndrome patients.

Abstract

Objective: To compare ACDF and ACCP in terms of neurological recovery and postoperative pain among CCS patients presenting at a tertiary care hospital, Karachi, Pakistan. Study Design: Prospective Cohort study. Setting: Department of Orthopedics, Dr. Ziauddin Hospital, Karachi. Period: February 2021 to March 2023. Methods: Patients diagnosed with CCS, presenting within 6 weeks of the index injury of age 45 to 60 years of either gender were included in the study. Group 1 included patients who underwent ACDF and Group 2 included patients who underwent ACCP. Patients in both groups were followed up to 2 years post-surgery. Outcomes were neurological outcome and pain. Data was analyzed using SPSS version 23. Results: There were no significant baseline differences between groups in terms of age, gender, hypertension, or diabetes. Neurological improvement was observed in 68% of the ACCP group compared to 32% in the ACDF group (p=0.025). However, 59.2% of ACDF patients reported significant pain relief, compared to 40.8% of ACCP patients (p=0.011). There were no significant readmissions or morbidity in either group. Conclusion: ACCP offers superior long-term neurological outcomes, while ACDF provides better postoperative pain relief. The choice of procedure should be based on individual patient needs, balancing neurological recovery and pain management considerations. Further multicentre studies are needed to generalize these findings.