Partial Vertebrae Resection Laterally to Harvest Supplemental Autograft Bone for Anterior Cervical Discectomy and Fusion: A Technical Note and Outcomes

Abstract

To evaluate the safety and effectiveness of partial vertebrae resection laterally through intervertebral space to harvest supplemental autograft bone for anterior cervical discectomy and fusion (ACDF). Patients who accepted 1-segment (n= 19, 38.2 months follow-up) or 2-segment (n= 17, 40.4 months follow-up) ACDF with supplemental autograft bone were included. Cervical lordosis (CL), segmental lordosis (SL), anterior segment height (ASH), and posterior segment height (PSH) on neutrally lateral radiography, and intervertebral fusion rate on computed tomography were measured. The operation time, intraoperative blood loss, Japanese Orthopedic Association score, visual analog scale around the neck or arm, Neck Disability Index, and complications were also recorded. Mean operation time was 86.2 and 115.6 minutes, and the intraoperative blood loss was 41.7 and 79.4 mL in cases with 1-segment and 2-segment ACDF, respectively. At the final visit, the visual analog scale score and Neck Disability Index significantly decreased, and the Japanese Orthopedic Association score significantly increased. Significant increases were observed in the ASH, PSH, CL, and SL after 2-segment ACDF. Significant increases were observed in the CL and SL after 1-segment ACDF, but not in the ASH and PSH. All the ASH, PSH, CL, and SL kept unchanged at the final visit. All cases acquired definite intervertebral fusion, and the incidence of cage subsidence was 5.3% after 1-segment and 17.6% after 2-segment ACDF at the final visit. Partial vertebrae resection laterally through the intervertebral space was a safe and effective method to harvest supplemental autograft bone for the ACDF.