Objective: To compare fusion time, Neck Disability scores, Pain scores, interbody height ratio and angulation, in cervical interbody fusion performed using tricortical graft or Ostapek cage, and a comparison between smokers and non smokers in fusion times.

Design: A prospective randomised study.

Subjects: Forty-two patients aged between 30 and 71years. Eighteen tricortical graft fusions, and 24 Ostapek cage fusions.

Outcome measures: Grading of fusion from plain radiographs, Neck Disability Scores, Pain scores, interbody height ratio, and interbody angulation.

Results: Mean time to good quality fusion was 4.66 months in the cage group and 5.97 months in the tri-cortical graft group with p< 0.5 and 5.00 months in the smoking population and 5.6 months in the non-smoking population with p< 0.5. At six months: mean percent NDI was 66.75 in the cage group and 50.67 in the tri-cortical graft group 0.1< p< 0.5;mean percent pain scores were 70.33 in the cage group and 34.50 in the tricortical graft group 0.02< p< 0.05; mean percent interbody height ratio was 98.68 in the cage group and 95.22 in the tricortical graft group 0.1< p< 0.5; mean change in interbody angle was 1.36° kyphosis in the cage group and 3.8° of kyphosis in the tricortical graft group 0.05< p< 0.1.

Conclusions: Tricortical graft fusion gives equal results to cage fusion and is much cheaper.