title: The impact of menopause on bone fusion after the single-level anterior cervical discectomy and fusion.
abstract: OBJECTIVE
  To evaluate the successful fusion rate in postmenopausal women with single-level anterior cervical discectomy and successful fusion (ACDF) and identify the significant factors related to bone successful fusion in pre- and postmenopausal women.
  
  
  METHODS
  From July 2004 to December 2010, 108 consecutive patients who underwent single-level ACDF were prospectively selected as candidates. Among these, the charts and radiological data of 39 women were reviewed retrospectively. These 39 women were divided into two groups : a premenopausal group (n=11) and a postmenopausal group (n=28). To evaluate the significant factors affecting the successful fusion rate, the following were analyzed : the presence of successful fusion, successful fusion type, age, operated level, bone mineral density, graft materials, stand-alone cage or plating with autologous iliac bone, subsidence, adjacent segment degeneration, smoking, diabetes mellitus, and renal disease.
  
  
  RESULTS
  The successful fusion rates of the pre- and postmenopausal groups were 90.9% and 89.2%, respectively. There was no significant difference in the successful fusion rate or successful fusion type between the two groups. In the postmenopausal group, three patients (10.8%) had successful fusion failure. In the postmenopausal group, age and subsidence significantly affected the successful fusion rate (p=0.016 and 0.011, respectively), and the incidence of subsidence in patients with a cage was higher than that in patients with a plate (p=0.030).
  
  
  CONCLUSIONS
  Menopausal status did not significantly affect bone successful fusion in patients with single-level ACDF. However, in older women with single-level ACDF, the combination of use of a cage and subsidence may unfavorably affect successful fusion.
authors: Department of Neurosurgery, Seoul National University Boramae Medical Center, Seoul, Korea.
authors: Sung Bae
authors: SB
authors: Park
authors: Department of Neurosurgery, Seoul National University College of Medicine, Seoul, Korea. ; Clinical Research Institute, Seoul National University Hospital, Seoul, Korea.
authors: Chun Kee
authors: CK
authors: Chung
authors: Department of Neurosurgery, Seoul National University Boramae Medical Center, Seoul, Korea.
authors: Sang Hyung
authors: SH
authors: Lee
authors: Department of Neurosurgery, Seoul National University Boramae Medical Center, Seoul, Korea.
authors: Hee-Jin
authors: HJ
authors: Yang
authors: Department of Neurosurgery, Seoul National University Boramae Medical Center, Seoul, Korea.
authors: Young-Je
authors: YJ
authors: Son
authors: Department of Neurosurgery, Seoul National University Boramae Medical Center, Seoul, Korea.
authors: Young Seob
authors: YS
authors: Chung
keywords: Bone mineral density; Cervical; Discectomy; Menopause; Successful fusion