Anterior cervical discectomy with or without fusion with ray titanium cage: a prospective randomized clinical study.
METHODS
A prospective randomized clinical study.


OBJECTIVE
To compare 2 surgical methods in the treatment of cervical radiculopathy caused by hard or soft disc herniation; namely, simple discectomy versus discectomy with an additional interbody fusion with a Ray titanium cage.


BACKGROUND
Although an interbody fusion after anterior decompressive surgery for hard or soft disc herniation is widely accepted, there is no scientific evidence that convincingly demonstrates that insertion of graft material for interbody fusion is necessary after discectomy and decompression of the nervous elements have been performed. To date, no randomized studies have compared simple discectomy with discectomy followed by an interbody fusion with a titanium cage.


METHODS
Eighty-six patients with symptoms of nerve root compression at 1 level were randomly allocated to either discectomy followed by fusion with a Ray titanium cage (40 patients) or to discectomy alone (46 patients). Clinical and radiologic follow-up was performed 3, 12, and 24 months after surgery.


RESULTS
There was no statistically significant difference between the 2 groups concerning self-reported satisfaction or severity of pain in the neck and arm. Two years after the operation, 86.1% of the patients treated with cage stated a good outcome versus 76.7% in the discectomy group (P = 0.44). The rate of fusion was 83.3% in the cage group versus 81.0% in the discectomy group (P = 0.30). Furthermore, after 2 years, also the rates of new adjacent disc degeneration or spondylosis were the same in both groups.


CONCLUSIONS
This study showed no statistically significant difference between simple discectomy and discectomy followed by interbody fusion with a titanium cage in the surgical treatment of cervical radiculopathy caused by disc herniation.
Hauerberg
John
J
University Clinic of Neurosurgery, The Neuroscience Center, Copenhagen University Hospital (Rigshospitalet), Denmark. john.hauerberg@rh.regionh.dk
Kosteljanetz
Michael
M
Bøge-Rasmussen
Torben
T
Dons
Kjeld
K
Gideon
Peter
P
Springborg
Jacob Bertram
JB
Wagner
Aase
A
D000328:Adult; D002574:Cervical Vertebrae / Q000601:surgery; D019299:Decompression, Surgical / Q000295:instrumentation / Q000379:methods; D015194:Diffusion Chambers, Culture; D017586:Diskectomy / Q000295:instrumentation / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011183:Postoperative Complications; D011446:Prospective Studies; D011843:Radiculopathy / Q000601:surgery*; D013123:Spinal Fusion / Q000295:instrumentation / Q000379:methods*; D014025:Titanium; D016896:Treatment Outcome
D014025:Titanium