A Comparative Study of Anterior Cervical Discectomy (ACD) with Anterior Cervical Discectomy with Fixation (ACDF)

ABSTRACT

Introduction: This study was conducted on 40 patients withsymptomatic cervical disc disease with one or two level discpathology. Clinical and radiological outcome was compared todetermine which technique was advantageous for treatment ofpatients with disc disease. Complications related to graft fusionfailures; subsidence, infection etc and donor site chronic painhave stimulated neurosurgeons to revert back to surgeries toavoid fusion.Methods: Patients were allocated to either ACD (n=21) orACDF (n=19) procedures. The standard Smith Robinsontechnique was performed in all patients in this study. Patientswere followed up clinically and radiologically according to thestudy protocol.Results: The clinical long term outcome was comparable inboth groups. Kyphosis and slow rate of fusion was noted withACD, but on long term follow up, patients were overallsatisfied. Donor site pain and graft related problems weremajor issues with ACDF. The issue of whether to fuse or not tofuse has not come to an end yet. This will require furtherrefinements in surgical technique, graft harvesting, and furtherstudies. Till then, both of these methods will be used forspecific indications.