A Study of Anterior Cervical Discectomy With or Without Fusion

Objectives : To retrospectively study and compare the clinical outcome of the patients undergoing anterior cervical discectomy (ACD), anterior cervical discectomy with fusion (ACDF), or anterior cervical discectomy with fusion and instrumentation (ACDFI) for cervical spondylosis. Methods : A retrospective analysis of 80 patients with cervical spondylosis who had undergone anterior cervical discectomy with or without fusion according to our preoperative assessment, were undertaken. Clinical outcome and associated complications in each group were analyzed to determine the need and efficacy of each procedure in these patients. Results : ACD and ACDF group had almost similar results in terms of hospital stay, mean time for improvement and patient satisfaction. ACDFI group had more prolonged hospital stay, took longer time to recover and to return to maximum normal status because of their poorer preoperative neurological status. Conclusions : Fusion is not routinely required, but it is indicated in patients with multisegmental disease, instability, loss of cervical lordosis, hard disc and osteophytic bars. Keys to achieve desirable clinical results are proper patient selection and adequate surgical decompression. No single gold standard procedure exists for the treatment of patients with cervical spondylosis and the treatment strategies need to be tailored to match the specific changes present in a given patient.