title: Three-level anterior cervical discectomy and fusion in elderly patients with wedge shaped tricortical autologous graft: A consecutive prospective series.
abstract: BACKGROUND
  Treatment of multilevel cervical spondylotic myelopathy/radiculopathy is a matter of debate, more so in elderly patients due to compromised physiology. We evaluated the clinical and radiological results of cervical fusion, using wedge-shaped tricortical autologous iliac graft and Orion plate for three-level anterior cervical discectomy in elderly patients.
  
  
  METHODS
  Twelve elderly patients with mean age of 69.7 years (65-76 years) were treated between April 2000 and March 2005, for three-level anterior cervical discectomy and fusion, using wedge-shaped tricortical autologous iliac graft and Orion plate. Outcome was recorded clinically according to Odom's criteria and radiologically in terms of correction of lordosis angle and intervertebral disc height span at the time of bony union. The mean follow-up was 29.8 months (12-58 months).
  
  
  RESULTS
  All the patients had a complete recovery of clinical symptoms after surgery. Postoperative score according to Odom's criteria was excellent in six patients and good in remaining six. Bony union was achieved in all the patients with average union time of 12 weeks (8-20 weeks). The mean of sum of three segment graft height collapse was 2.50 mm (SD = 2.47). The average angle of lordosis was corrected from 18.2 degrees (SD = 2.59 degrees ) preoperatively to 24.9 degrees (SD = 4.54 degrees ) at the final follow-up. This improvement in the radiological findings is statistically significant (P < 0.05).
  
  
  CONCLUSIONS
  Cervical fusion with wedge-shaped tricortical autologous iliac graft and Orion plate for three-level anterior cervical discectomy is an acceptable technique in elderly patients. It gives satisfactory results in terms of clinical outcome, predictable early solid bony union, and maintenance of disc space height along with restoration of cervical lordosis.
authors.forename: Suk Ha
authors.initials: SH
authors.lastname: Lee
authors.forename: Kwang Jun
authors.initials: KJ
authors.lastname: Oh
authors.forename: Kwang Su
authors.initials: KS
authors.lastname: Yoon
authors.forename: Sung Tae
authors.initials: ST
authors.lastname: Lee
authors.forename: Dilbans S
authors.initials: DS
authors.lastname: Pandher