A survey of the peri-operative management of patients undergoing anterior cervical decompression in the UK and Eire.
The peri-operative management of patients undergoing single level anterior cervical decompression (ACD) in neurosurgical departments in the UK and Eire has been surveyed. Eighty-eight per cent (132 of 150) of consultant neurosurgeons responded and of these 118 perform ACD. Nearly all (96%) respondents use interbody grafts and most of these use autologous bone (63%). A small minority (4%) never use interbody grafts. Forty-four per cent of surgeons use the same surgical technique irrespective of the underlying pathology (Cloward 57%: Smith Robinson 33%; ACD without graft 8%). Surgibone grafts are used by 25% and BOP grafts by 5%, but 15% of surgeons have abandoned artificial graft materials because of concerns about non-union. This survey has revealed a diverse range of practice amongst UK neurosurgeons. A prospective randomized trial is required to identify whether the theoretical benefits of interbody grafting following cervical discectomy justify donor site morbidity and the expense and risks of substitute graft materials.
Harland
S P
SP
Academic Department of Neurosurgery, Addenbrookes Hospital, Cambridge, UK.
Laing
R J
RJ
D016025:Bone Transplantation; D002574:Cervical Vertebrae / Q000473:pathology / Q000601:surgery*; D003952:Diagnostic Imaging; D006801:Humans; D007494:Ireland; D013117:Spinal Cord Compression / Q000175:diagnosis / Q000601:surgery*; D013123:Spinal Fusion; D006113:United Kingdom