Does Plate Construct Improve the Result of 1- or 2-level Anterior Cervical Fusion?

Abstract

This study compared the results of anterior cervical discectomy and fusion (ACDF) with autograft alone with those of ACDF with plate construct through a retrospective review of 76 patients with 1- or 2-level degenerative cervical disorder at least more than 3 years follow-up. Group A (n=40) had undergone 1-level (n=26) or 2-level (n=14) fusion and ACDF with autograft alone. Group B (n=36) had undergone 1-level (n=24) or 2-level (n=12) fusion and ACDF with plate construct. The following parameters were analyzed: fusion rate, the change of Cobb angle, adjacent segment degeneration (ASD), clinical outcome, and the rate of complications. There was a significant difference in fusion rate between groups A and B (P=0.057). Group B had a significant increase in the change of Cobb angle than group A (P=0.005). ASDs were developed in 16 of 40 cases (40%); 1-level fusion (23.1%); 2-level fusion (71.4%) in group A; and 4 of 36 cases (11%); 1-level fusion (4.2%); 2-level fusion (25.0%) in group B. There was a significant difference in ASD between groups A and B. There was no significant difference in the rate of complications. We suggest that plate construct is necessary to reduce the development of pseudoarthrosis, the change of Cobb angle, especially ASD in the result of anterior cervical fusion.