Anterior cervical discectomy: is fusion necessary?

Object. A prospective, randomized trial was performed to compare the efficacy of anterior cervical discectomy (ACD) with ACD and fusion (ACDF) for the treatment of cervical spondylosis in patients with neurological compromise. Methods. Forty-four patients underwent ACD and 40 underwent ACDF. Operative time and length of hospital stay were shorter and there was less need for analgesia in the ACD group. It was found that whereas the incidence of fusion was greater in the ACDF group compared to the ACD group (97 compared with 70%, respectively; p < 0.01), patient satis faction and a return to preoperative activity level was similar between groups. Conclusions. Analysis of the results suggests that the addition of a fusion procedure may be unnecessary.