Role of Anterior Cervical Decompression Fusion (ACDF) and Plating in Patients with Lower Cervical Caries Spine

Objective:  We assessed the neurologic status of patients with cervical spine caries after anterior cervical decompression fusion and plating in terms of muscle power measured by MRC (medical research council) grade and functional status measured by Nurick grade. Materials and Methods:  A descriptive case series study was conducted and 36 subjects with lower cervical spine (C3 – C7) were included with cervical spine caries who needed anterior cervical decompression and plating operated by the department of Neurosurgery, KEMU/Mayo Hospital. The cervical spine TB was confirmed using an MRI plain and contrasted cervical spine. Post-surgical neurological examinations were performed on the 1st, 7th, 21st, and 42nd days and the 3rd and 6th months after surgery. The neurological state was measured in terms of muscle power measured by MRC grades and functional outcome was assessed from Nurick grades. Results:  The mean age of the patients was 37.0 ± 14.4 years. The majority of patients had C5 caries spine (28%) and the least had C7 caries spine (14%). Most of the patients had pre-operative MRC grade 3 (41.7%). The majority had Nurick’s grade 5 (55.6%). 17% of patients had post-operative hoarseness of voice. 31% of the patients had post-operative dysphasia which improved by 3 weeks. 3% developed a new neurological deficit in the form of deterioration of muscle power measured by MRC grade during 6 months’ follow-up time. Conclusion:  All follow-up improvements were statistically significant in terms of pre-operative status.