Long-term Results of Surgical Treatment for Symptomatic Anterior Cervical Osteophytes: A Case Series With Review of the Literature.

Abstract

Presentation of a case series (10 patients) with surgical treatment of symptomatic anterior cervical osteophytes, a review of the latest literature and discussion of surgical methods. To present our results of the surgical treatment and compare them with the existing literature. On the basis of the gathered data, we aim to propose an optimal choice of surgical treatment. Anterior cervical osteophytes rarely cause symptoms that require surgical treatment, which disables bigger cohort analysis. Surgery always includes anterior osteophyte resection. Some authors propose instrumented anterior fusion after osteophyte resection as the first choice of surgery in order to prevent regrowth of osteophytes, whereas others support resection without fusion because of beneficial long-term results. Diagnostics included plain radiography, contrast esophagography, computed tomography and/or magnetic resonance imaging. Treatment consisted of left lateral cervicotomy and osteophytectomy. We performed a systematic review of the literature from 2006. Average age at surgery was 69.5 years (63-77 y), average follow-up 61.9 months (15-117 mo). Twenty-five osteophytes were resected, with average size of 12.7 mm (4-22 mm) preoperatively and 5.12 mm (0-12 mm) at final follow-up. Average functional outcome swallowing scale score before surgery was 3.3 (2-5) and 1.2 (0-5) at final follow-up. Only 1 patient had reoccurrence of symptoms because of osseous etiology. Symptomatic ventral cervical osteophytes can be successfully treated by surgery. In the majority of patients, osteophytes do not regrow significantly in the long term, precluding the need for prophylactic instrumented fusion after osteophyte resection.