Radiological and Clinical Comparison of the Results of Patients with Fusion and Unfusion Cervical Anterior Microdiscectomy with the Help of Cases and Literature

Objective: In this study, we aimed to show the superiority of fused anterior cervical discectomy and fusion (ACDF) with fuseless anterior cervical discectomy by comparing the clinical and radiological follow-up results of patients with ACD and ACDF. Methods: Between 2001 and 2005, 67 patients with cervical disc disease, who underwent anterior cervical intervention, were included in this study. Fifty patients underwent ACD. In 31 cases, cage system and osteoinductive graft material (demineralized bone matrix) were used and 11 cases were treated with plate anterior cervical discectomy in addition to cage system. The mean follow-up period was 12 months (6 months-18 months) in the ACD group. The mean follow-up period in the ACDF group was 12 months (6 months-18 months). All ACD and ACDF patients were evaluated according to the criteria of direct cervical grafillary and Odom criteria taken at the postoperative early period, 6 months and 12 months. Results: Fifty-five patients with ACD and 42 patients with ACDF were included in the study group. The mean age of the patients in the ACD group was 41 years (the youngest was 29, the oldest was 59 years old) and the mean age of the ACDF group was 46 years (the youngest was 30, the oldest was 69 years old). The difference was not statistically significant (p>0.05). There was no decrease in intervertebral disc height and foramen height in patients undergoing ACDF. No kyphosis was seen in ACDF patients. Conclusion: According to the patient group who underwent ACD and ACDF and followed for 24 months, it was seen that the intervertebral disc height, foramen height and cervical lordosis were preserved in ACDF. No intervertebral cage was seen in the cervical corpus in any patient of ACDF. Clinical and radiological findings showed that clinical and radiological outcomes of patients with ACDF were better than ACD patients. The necessity of fusion of the anterior cervical discectomy and the use of instrumentation are discussed in the literature. Because of this reason, the results of our study will be meaningful in terms of contributing to future research.