The long-term clinical outcome of patients undergoing anterior cervical discectomy with and without intervertebral bone graft placement.
OBJECTIVE
This retrospective study provides data on the long-term clinical outcomes of patients with either anterior cervical discectomy alone (ACD) or anterior cervical discectomy with intervertebral bone graft placement (ACDF).


METHODS
A questionnaire was mailed to 525 patients who had undergone ACD (290 patients) or ACDF (235 patients) at least 2 years previously. All procedures were performed by University of Nebraska Medical Center faculty in the Section of Neurosurgery. The follow-up period averaged 8.1 years, with a range of 2 to 14 years.


RESULTS
Two hundred sixty-two (49.9%) patients responded to the questionnaire. There was no demographic difference between respondents and nonrespondents (P > 0.05). Respondents who underwent ACDF reported fewer problems with pain than did those who underwent ACD (P < 0.05). A higher percentage of respondents with ACDF reported that they had normal function than did those who underwent ACD (P < 0.05). When limited to respondents who underwent first-time, single-level operations (191 patients), similar results were obtained for the pain parameter (P < 0.05) but not for the level of function (P = 0.25). Patients with longer follow-up periods had fewer problems with pain and better levels of function (P < 0.05).


CONCLUSIONS
Patients who underwent ACD or ACDF did well and benefited from their operations. Those who underwent ACDF did better than those who underwent ACD. Length of follow-up was also an important predictor of current levels of function and pain.
Department of Surgery, University of Nebraska Medical Center, Omaha 68198-2035, USA.
W
W
Thorell
J
J
Cooper
L
L
Hellbusch
L
L
Leibrock
D000328:Adult; D000368:Aged; D016025:Bone Transplantation; D002574:Cervical Vertebrae / Q000601:surgery*; D017586:Diskectomy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination; D010043:Outcome and Process Assessment, Health Care; D011183:Postoperative Complications / Q000175:diagnosis*