We conducted a prospective, randomised study of 42 cervical interbody fusions undertaken with either an autologous tricortical graft or a cage. The factors assessed in the two groups were: (1) time taken to achieve fusion; (2) neck disability index; (3) pain score; (4) interbody height ratio; (5) interbody angle and (6) the influence of smoking on fusion.

No statistical difference was seen in the time taken to achieve fusion, neck disability index, interbody height ratio, or interbody angles. Smoking did not have any effect on the fusion process. The pain score was significantly lower in the tricortical graft group at six months. We conclude that both methods of fusion give similar results, although tricortical graft fusion is cheaper than cage fusion, and is more effective in reducing the pain score.

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.