A Comparison of Clinical and Radiological Outcome Between Two-Level Discectomy and One-Level Corpectomy for Cervical Degenerative Disc Disease

ABSTRACT

OBJECTIVE: The clinical and radiographic success of a two-level discectomy and autologous iliac bone fusion with anterior cervical plate fixation (ACDFP) was compared with that of a one-level corpectomy and fusion using a titanium mesh cage (corpectomy) for the treatment of degenerative cervical disc disease. METHODS: From January 2004 to December 2007, there were 45 consecutive cases of two disc level degenerative cervical disc disease treated with either ACDFP or corpectomy. The medical records and radiological studies were reviewed, retrospectively. The clinical outcomes were measured using Odom's criteria. The radiologic assessment was performed using images showing the lordosis and bony fusion. RESULTS: Twenty-seven patients were treated with ACDFP. Eighteen patients were treated with corpectomy. The clinical outcome was excellent or good in 25 cases (93%) and 17 cases (94%) treated with ACDFP and corpectomy, respectively. The fusion rate was 96% and 94% for ACDFP and corpectomy, respectively. There was a slight increase in the cervical lordosis in both groups, but there was no significant difference between the 2 groups. There were no irriversible complications in both groups. Reversible complications were encountered in 1 case of corpectomy, and 7 cases of ACDFP, which were mainly associated with donor site. CONCLUSION: Either a ACDFP or a corpectomy provides good clinical outcome and similar bone fusion rates for degenerative disc diseases. However, absence of donor site complications makes a corpectomy better than ACDFP.