The arthrodesis rate in multilevel anterior cervical fusions using autogenous fibula

Study Design. This study was a roentgenographic review of 145 patients who underwent multilevel anterior cervical arthrodesis using autogenous fibula. Objective. To determine the arthrodesis rate in multilevel cervical fusions using autogenous fibula. Summary of Background Date. Previous studies have shown an unacceptably high rate of nonunions with multilevel anterior cervical arthrodesis. However, this has not been the clinical experience of the author's group. Methods. Lateral roentgenograms taken a minimum of 2 years after surgery were reviewed independently by two radiologists. If either radiologist questioned any fusion level, the final decision was made on the basis of flexion-extension roentgenograms. Results. An overall union rate of 90% and 94% per patient was found for each level of attempted fusion. A solid arthrodesis was achieved in 93% of the patients with two-level fusions. and 84% of the three-level fusions were solid. The difference was not statistically significant. Conclusion. Autogenous fibula used as a strut graft results in an acceptable union rate for multilevel anterior cervical arthrodesis.