Single and Two-Level Anterior Cervical Diskectomy and Arthrodesis, Autograft versus Allograft: Radiographic and Clinical Outcomes

Introduction: A prospective study compared clinical and radiographic outcomes associated with one- or two-level anterior cervical microdiskectomy (ACD) with either auto- or allograft arthrodesis (without plating). Methods: Between 1993–1998, 176 consecutive patients (78 females, 98 males; mean age, 52 yrs) underwent one- or two-level ACD with autograft (iliac crest). Allograft (fibula) was used in another 151 patients (81 females, 70 males; mean age, 50 years). Outcomes were assessed at a 2-year follow-up examination (available in 71% of patients). Arthrodesis was evaluated by an independent observer. Charts, radiographs, and telephone questionnaires were analyzed. Results: There were 104 autograft and 70 allograft single-level and 72 autograft and 81 allograft two-level fusions. No patients died. Approach-related complications (similar in both groups) included hoarseness/dysphagia (2.7%), neurological deterioration (1.6%), and epidural hematoma (0.3%). Medical complications included pulmonary embolism (0.3%) and respiratory failure (0.3%). Hip pain, infection, dehiscence and meralgia paresthetica were associated with autografts (9%)...