title: Long-term results after cervical anterior fusion using an autologous bone graft (Williams-Isu method).
abstract: OBJECTIVE
  Cervical anterior fusion with autologous bone grafts (Williams-Isu method) is a modified, accepted method to treat spinal degenerative disease. Here we report minimum 10-year outcomes.
  
  
  METHODS
  Of 101 patients we treated by cervical anterior fusion using the Williams-Isu method, 50 patients were followed up for a mean of 177 months. Among the 51 patients lost to long-term follow-up 12 were contacted by telephone; they reported their condition as good and none required reoperation. We evaluated their clinical outcomes on the Japan Orthopedic Association (JOA) score and assessed radiologic findings.
  
  
  RESULTS
  The average JOA score was 12.5 preoperatively, 15.9 at 2 years after surgery (recovery rate 74.9%), and 15.5 at final follow-up (recovery rate 67.0%). All 5 reoperated patients were treated on the level adjacent to the original lesion. Radiographically, cervical alignment changed from 12.5° to 9.0°, the fused segment angle changed from 5.4° to -0.6°. Although worsening of the fused segment angle did not affect the clinical results, it did affect postoperative cervical sagittal alignment. Cervical alignment and range of motion (ROM) were not different between reoperated (group I) and nonreoperated patients (group II). Fused segment angle worsening was milder than expected in group I.
  
  
  CONCLUSIONS
  The long-term results after the Williams-Isu method were good. The fused segment angle loss of approximately 6° did not affect long-term outcomes although it did affect sagittal cervical alignment. Postoperative worsening of the fused segment angle and hyper ROM changes in the adjacent level were not related to the need for reoperation in our study.
authors.affiliation: Department of Neurosurgery, Chiba Hokuso Hospital, Nippon Medical School, Chiba, Japan. Electronic address: kyongson@nms.ac.jp.
authors.forename: Kyongsong
authors.initials: K
authors.lastname: Kim
authors.affiliation: Department of Neurosurgery, Kushiro Rosai Hospital, Hokkaido, Japan.
authors.forename: Toyohiko
authors.initials: T
authors.lastname: Isu
authors.affiliation: Department of Neurosurgery, Kushiro Rosai Hospital, Hokkaido, Japan.
authors.forename: Morimoto
authors.initials: M
authors.lastname: Daijiro
authors.affiliation: Department of Neurosurgery, Kushiro Rosai Hospital, Hokkaido, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Sugawara
authors.affiliation: Department of Neurosurgery, Kushiro Rosai Hospital, Hokkaido, Japan.
authors.forename: Ryoji
authors.initials: R
authors.lastname: Matsumoto
authors.affiliation: Department of Neurosurgery, Kushiro Rosai Hospital, Hokkaido, Japan.
authors.forename: Masanori
authors.initials: M
authors.lastname: Isobe
authors.affiliation: Department of Neurosurgery, Chiba Hokuso Hospital, Nippon Medical School, Chiba, Japan.
authors.forename: Shiro
authors.initials: S
authors.lastname: Kobayashi
authors.affiliation: Department of Neurosurgery, Nippon Medical School, Chiba, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Teramoto
mesh_terms: D000328:Adult; D000368:Aged; D016025:Bone Transplantation / Q000379:methods*; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000453:epidemiology; D011859:Radiography; D016059:Range of Motion, Articular; D012086:Reoperation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D013123:Spinal Fusion / Q000379:methods*; D013131:Spine / Q000000981:diagnostic imaging; D014182:Transplantation, Autologous; D016896:Treatment Outcome