A prospective randomized study of anterior single-level cervical disc operations with long-term follow-up: surgical fusion is unnecessary.

Abstract

After 40 years of experience with anterior cervical operations, whether to fuse is still controversial. This study seeks to answer this question. In this prospective randomized study, we operated on 91 patients with single-level cervical root compression using three different methods: 1) discectomy without fusion, 2) fusion with autologous bone graft, and 3) fusion with autologous bone graft plus plating. After 4 years of follow-up, the radiological results indicated that complete bony union was achieved in almost all cases. A slight kyphosis developed in 62.5% of the patients who had undergone discectomy, 40% of the patients who had undergone fusion, and 44% of the patients who had undergone fusion plus plating (not significant). The clinical outcomes were good for 76% of the patients who had undergone discectomy, 82% who had undergone fusion, and 73% who had undergone fusion plus plating. The outcomes were poor in 0, 4, and 4%, respectively (not significant). According to this study, satisfactory results can be achieved by performing simple discectomy to treat single-level cervical root compressive disease.