Abstract
Purpose
This study compared the results of anterior cervical discectomy and fusion with autogenous bone graft (AFA) with or without plate fixation through a retrospective review of one or two-level degenerative cervical disorder, and the average follow-up was 6 years.
Materials and Methods
Group A (n=40) underwent one-level (A-1/26) or two-level (A-2/14) fusion and AFA alone. Group B (n=36) underwent one-level (B-1/24) or two-level (B-2/12) fusion and AFA with plate construct. The following parameters were analyzed: the fusion rate, the change of Cobb's angle, the adjacent level degeneration (ALD), the clinical outcome and the rate of complications.
Results
There was a significant difference in the fusion rate between group A and B (p=0.028). Group B had a significant increase in the change of Cobb's angle compared to groups A (p=0.004). ALD were developed in 16 of 40 cases (40%) in group A, and in 4 of 36 cases (11%) in group B. There was a significant difference in ALD between group A and group B (p=0.004).
Figures and Tables
Fig. 1
This forty six year-old female patient (case 57) with a cervical disc herniation at C5-6 underwent anterior cervical discectomy and fusion with an autogenous iliac tricortical bone graft, and plate fixation. (A) Preoperative lateral radiograph shows degenerative disc space narrowing at C5-6. (B) Postoperative lateral radiograph shows the bone graft with plate fixation on C5-6. (C) Lateral radiograph after 1 year shows solid bony fusion at C5-6. (D) Lateral radiograph after 3 years shows normal sagittal alignment and no visible degenerative changes at the adjacent segment.
![jkoa-43-338-g001](/upload/SynapseData/ArticleImage/0043jkoa/jkoa-43-338-g001.jpg)
Fig. 2
This thirty six year-old female patient (case 32) with a cervical myelopathy and disc herniation at C4-5 underwent anterior cervical discectomy and fusion with an autogenous iliac tricortical bone graft. (A) Preoperative lateral radiograph shows degenerative disc space narrowing at C4-5. (B) Postoperative lateral radiograph shows ACDF with bone graft only at C4-5. (C) Lateral radiograph after 2 years shows bone graft collapse with pseudoarthrosis at the distal end of the bone graft at C4-5, with progressive kyphosis. (D) Lateral radiograph after 8 years shows solid fusion at C4-5 with severe degenerative changes at C3-4 and local kyphosis.
![jkoa-43-338-g002](/upload/SynapseData/ArticleImage/0043jkoa/jkoa-43-338-g002.jpg)
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