Comparative Study of Clinical Outcomes of Anterior Cervical Discectomy and Fusion Using Autobone Graft or Cage with Bone Substitute

STUDY DESIGN: A retrospective study. PURPOSE: To compare the clinical and radiological outcomes of autogenous bone graft and cage with bone substitute for anterior cervical discectomy and fusion. OVERVIEW OF LITERATURE: The clinical outcomes of cage with bone substitute for anterior cervical discectomy and fusion is satisfactory. METHODS: Eighty four patients who underwent cervical spine surgery between February 2004 and April 2009 were included. Fifty-nine patients were approached anteriorly and underwent anterior cervical discectomy and fusion by the Smith-Robinson method (Group A), and 25 patients underwent fusion by decompression of the cervical spine and cage with bone substitute (Group B). We measured and evaluated the postoperative period until patients were able to ambulate, for pre- and postoperative symptomatic improvement, postoperative complications, pre- and postoperative change of lordosis, degree of endplate collapse or subsidence, and fusion rate and period of union. RESULTS: By Robinson's criteria, respectively 45, 10 and 4 patients in Group A experienced excellent, good and fair symptomatic improvement, and respectively 19, 5 and 1 patients in Group B experienced excellent, good and fair symptomatic improvement. The postoperative period in which patients became ambulant and the period of hospital stay was significantly shorter in Group B. Increase of lordosis at final follow up after surgery was significantly larger in Group A, as was the fusion period. Significantly more endplate collapse occurred in Group B. CONCLUSIONS: Of patients who had anterior cervical discectomy and fusion, results of both groups were both satisfactory.