Abstract
Study design: Retrospective review of patients with cervical spondylosis treated with three-level anterior cervical discectomy and fusion with plate fixation.
Objective: To assess the radiographic and clinical outcome of three-level instrumented anterior cervical discectomy.
Summary of Background data: Three-level cervical discectomy without plate fixation has shown high rates of pseudarthrosis and poor outcomes. The addition of internal fixation may improve these parameters.
Methods: 46 patients were observed for an average of 17.6 months (range, 6–51). All had three level anterior cervical discectomy and fusion with tricortical iliac crest autograft (4 cases), fibular ring allograft (38 cases), or titanium cage (four cases). Allografts and cages were filled with iliac crest autograft. All patients had semi-rigid plating. Clinical and radiographic follow-up data were obtained. Clinical outcomes were measured as described by Robinson and with the Nurick scale.
Results: Forty-four patients achieved solid fusion. Two patients had additional surgery for junctional disease, and in one of them pseudarthrosis repair was also performed. One asymptomatic pseudarthrosis was noted. With a successful result defined as an excellent or good outcome accompanied by significant pain relief, 38 patients had a successful result (83%). Radiographic adjacent level disease was diagnosed in 11 patients postoperatively and was symptomatic in 5.
Conclusion: Three-level anterior cervical discectomy with plate fixation has a high rate of fusion, a low complication rate, and acceptable outcome in the treatment of multilevel cervical spondylosis.
Theses abstracts were prepared by Professor Roger Lemaire. Correspondence should be addressed to EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.
