J Korean Soc Spine Surg.  2002 Sep;9(3):238-244. 10.4184/jkss.2002.9.3.238.

Three-level Anterior Cervical Discectomy and Fusion with Cervical Plate

• Lee SH
• Lee ST
• Lee YK
• Shim JI
• Kim TS
• Kim YB
• Ahn HS

• KMID: 2003231
• DOI: http://doi.org/10.4184/jkss.2002.9.3.238

Abstract

STUDY DESIGN: Retrospective study.
OBJECTIVES
To evaluate the clinical and radiological outcomes by the method of three-level anterior cervical discectomy and fusion with cervical plate. SUMMARY OF LITERATURE REVIEW: The arthrodesis rate and outcome for patients having three-level anterior cervical discectomy and fusion procedures is disappointing. The success of arthrodesis depends on several factors including bone graft type, size, and additional anterior plate fixation.
MATERIALS AND METHODS
Five patients (average age, 69 years; all males) were observed. All had a anterior discectomy, placement of autogenous tricortical iliac bone graft at three-levels and application of a Orion plate. Clinical and radiologic results of bony union, cervical lordosis and intervertebral disc height were assessed.
RESULTS
All clinical symptoms of patients had been resolved after operation. The postoperative scores by the criteria of Odom are 2 in excellent and 3 in good. The bony unions were achieved in all cases in the average 12 weeks after surgery (minimum 8 weeks, maximum 20 weeks). The sum of three-level intervertebral disc height in average was increased from 14.8 mm preoperatively to 25.4 mm postoperatively. The average angle of cervical lordosis was corrected from 18o preoperatively to 27o postoperatively.
CONCLUSIONS
The three-level anterior cervical discectomy and fusion with Orion plate and autogenous tricortical iliac bone graft results in effective surgical treatment, which produces good clinical outcome, early and solid bony union, restoration of the normal cervical lordosis and disc space height.

Keyword

Cervical spine; Anterior discectomy; 3-level fusion; Orion plate

MeSH Terms

Animals
Arthrodesis
Diskectomy*
Humans
Intervertebral Disc
Lordosis
Retrospective Studies
Transplants

Figure

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  Fig. 1. Preoperative radiograph shows decreased cervical lordosis (160) with severe narrowing of disc space, osteophyte formation and spondylolisthesis C4.

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  Fig. 2. Preoperative MRI shows 3-level (C4-5-6-7) disc herni ation with cord impingement.

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  Fig. 3. 3-level anterior discectomy and fusion was done by using autogenous tricortical iliac bone graft and Orion plate fixation. 12 weeks later, postoperative radiograph shows solid bony union and restoration of lordosis (340).

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