Anterior Decompression And Fusion (ACDF) With Rigid Anterior Plate Fixation For One-level Cervical Disc Herniation

STUDY DESIGN: A review of 35 consecutive patients at a single institution who underwent one-level anterior cervical discectomy and fusion (ACDF) with rigid anterior plate fixation with allograft or autograft. OBJECTIVE: To discuss the clinical outcome in patients undergoing one-level ACDF with rigid anterior plate fixation and address the efficacy of allograft to autograft with respect to fusion rate. SUMMARY OF BACKGROUND DATA: Although autograft is considered the gold standard in achieving optimal fusion, when compared with allograft in noninstrumented one-level ACDF and in plated and nonplated multilevel ACDF, the efficacy of allograft to autograft in one-level ACDF with rigid anterior plate fixation is not thoroughly understood. METHODS: From March 2005 to December 2006 thirty-five consecutive patients (mean age, 50.3 years) at a single institution who underwent one-level ACDF with rigid anterior plate fixation with allograft (n = 18) or autograft (n = 17) were reviewed for radiographic fusion (mean, 11 months), of which male 20, female 15,and the highest and lowest cervical disc herniation level were C3,4 and C6,7,respectively.RESULTS: Solid fusion was achieved in 33 patients (94.3%) 6 months after operation. Fusion was noted in 94.4% of the allograft patients, whereas 94.1% of the autograft cases achieved fusion. No statistically significant difference was noted between allograft to autograft with regard to fusion rate (P > 0.05). No instrument complications occur, all patients acquire excellent or good clinical outcome. CONCLUSION: The use of allograft or autograft bone in properly selected patients for one-level ACDF with rigid anterior plate fixation can result in high fusion rates with excellent and good clinical outcomes.