Long-term results after anterior cervical discectomy and fusion with allograft and plating - A 5-to 11-year radiologic and clinical follow-up study

Study Design. A retrospective review. Objectives. To determine the clinical and radiologic outcomes beyond 5 years after anterior cervical discectomy and fusion with allograft and plating. Summary of Background Data. Anterior cervical discectomy and fusion is commonly performed for cervical disc disease. The routine use of allografts and plating, though increasing in popularity, has not been well studied for long-term results and complications. Methods. Seventy-one patients who had anterior cervical discectomy and fusion with allograft and plating an average of 7.2 years prior responded to an invitation to return for a follow-up clinical and radiographic review. Results. At final review, symptom resolution remained greater than 82% and fusion occurred in 92.6% of the disc spaces operated on. No graft extrusion or migration occurred. Based on our strict criteria, the rates of collapse and subsidence were high, at 47.9% (34 patients) overall. However, in only 6 patients (8.5%) did segmental kyphosis result, none of whom required any revision surgery in the follow-up period. Implant complications occurred in 7 patients (9.9%), none of whom required revision surgeries. Adjacent level degeneration occurred in 52 patients (73.2%). Further cervical spine surgeries were required in 14 patients (19.7%), 2 for inadequate decompression, and 12 for adjacent level disease. Segmental and global cervical lordosis was restored and maintained by the surgery over the study period. Conclusions. The use of allografts and plate fixation in combination for anterior cervical discectomy and fusion does not compromise the radiologic and clinical outcomes while providing the advantages of donor site morbidity elimination, restoration of cervical segmental lordosis, and not requiring postoperative immobilization.