J Korean Orthop Assoc.  2008 Jun;43(3):338-346. 10.4055/jkoa.2008.43.3.338.

Anterior Cervical Fusion with Autogenous Iliac Bone Graft with or without Plate Fixation for Degenerative Cervical Spinal Disorders

Affiliations
  • 1Department of Orthopedic Surgery, College of Medicine, Research Institute of Clinical Medicine, Chonbuk National University Hospital, Jeonju, Korea. kysong@chonbuk.ac.kr
  • 2Department of Orthopedic Surgery, Gwangju Veterans Hospital,Jeonju, Korea.
  • 3Jeju National University, Jeju, Korea.

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).
CONCLUSION
We think that plate augmentation is necessary for the maintenance of lordosis, for reducing the pseudarthrosis and adjacent level degeneration, and to improve the clinical outcome after treatment of degenerative cervical disorders.

Keyword

Degenerative cervical disorder; Anterior cervical fusion; Autogenous iliac bone graft; Plate Fixation

MeSH Terms

Animals
Diskectomy
Follow-Up Studies
Lordosis
Pseudarthrosis
Retrospective Studies
Transplants

Figure

  • 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.

  • 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.


Cited by  2 articles

Significance of Mal-alignment after Anterior Cervical Arthrodesis in Degenerative Cervical Spinal Disorders
Kyung-Jin Song, Kwang-Bok Lee, Hun Park, Byeong-Yeol Choi, Eea-Sub Chung
J Korean Orthop Assoc. 2011;46(1):35-41.    doi: 10.4055/jkoa.2011.46.1.35.

Current Concept on the Surgical Treatment by Anterior Approach in Degenerative Cervical Radiculopathy
Byung-Wan Choi, Kyung-Jin Song
J Korean Soc Spine Surg. 2011;18(1):34-41.    doi: 10.4184/jkss.2011.18.1.34.


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