Anterior Cervical Fusion: A Retrospective Analysis of 152 Cases

ABSTRACT

Anterior cervical fusion has enjoyed an increasing acceptance and frequency of utilization in the treatment of symptomatic degenerative, traumatic, and neoplastic disorders. Since the introduction of plate systems, cervical fusion with fixation has become popularized. We present our experiences of 152 cases of cervical fusion in degenerative and traumatic lesions, focusing on their surgical results and complications, along with our opinions about the various plate systems we used. Between March 1993 and May 1996, 152 patients with symptomatic degenerative and traumatic cervical lesions between C3-4 and C7-T1 levels were treated with anterior cervical fusions. These patients were retrospectively studied according to their medical records and radiological studies. A comparison between various plate systems were also done. There were 110 men and 42 women, aged from 21 to 77 years. Mean follow up period was 17 months. Mean fused segments were 1.4. Various plate systems were used Caspar plate system in 14 patients; Top plate in 102; Orion plate in 21; and none in 15. Dislodgement of bone graft, screw loosening, and fusion failure that required reoperation were occurred in 8 cases. None of them were initially treated with unicortical type screws. Asymptomatic esophageal perforation was developed in one case among them. In conclusion, anterior cervical fusion with screw plate system can be carried out with acceptable complication rate. Although relative follow up period was short, we concluded that the locking type screw plate system was superior than the classic bicortical screw system in their procedural simplicity, unnecessary penetration of posterior cortex, and elimination of the fear for the neurological complication.