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A prospective randomized study of anterior single-level cervical disc operations with long-term follow-up: surgical fusion is unnecessary

S Savolainen, J Rinne, J Hernesniemi
Neurosurgery 1998, 43 (1): 51-5

OBJECTIVE: After 40 years of experience with anterior cervical operations, whether to fuse is still controversial. This study seeks to answer this question.

METHODS: In this prospective randomized study, we operated on 91 patients with single-level cervical root compression using three different methods: 1) discectomy without fusion, 2) fusion with autologous bone graft, and 3) fusion with autologous bone graft plus plating.

RESULTS: After 4 years of follow-up, the radiological results indicated that complete bony union was achieved in almost all cases. A slight kyphosis developed in 62.5% of the patients who had undergone discectomy, 40% of the patients who had undergone fusion, and 44% of the patients who had undergone fusion plus plating (not significant). The clinical outcomes were good for 76% of the patients who had undergone discectomy, 82% who had undergone fusion, and 73% who had undergone fusion plus plating. The outcomes were poor in 0, 4, and 4%, respectively (not significant).

CONCLUSION: According to this study, satisfactory results can be achieved by performing simple discectomy to treat single-level cervical root compressive disease.

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