Anterior Cervical Discectomy and Fusion With Al lograft and Anterior Plating A Report on 219 Patients/469 Levels With a Minimum of 2-year Follow-up

摘要

Anterior cervical fusion with autograft is a standard technique for the treatment of cervical disc disease but is associated with a high rate of donor site complications. The use of allograft and plating has become a common approach to avoid these complications. This paper reports the results of a retrospective chart and radiographic review of anterior cervical discectomy and fusion patients operated on by a single surgeon using allograft and anterior plating with a minimum of 2-year follow-up using a prospective surgical operative algorithm. The objective of the study was to determine fusion rates with allograft and review the technical factors that impact successful fusion. Between 1999 and 2002, the senior author performed 219 anterior cervical fusions. The average fusion rate across all patients was 94.5%. Only 4 patients required reoperation for pseudoarthrosis during the study. The complication rate was low (5.9%) and included vocal cord paralysis, dysphasia, wound infection, and respiratory distress. Patients with dynamic plate constructs had a lower pseudoarthrosis rate than did those with static plates. Anterior cervical fusion with allograft and plate is a suitable alternative to fusion with autograft and produces high rates of fusion even in patients undergoing 3 and 4-level procedures while avoiding the risks associated with autograft harvest.