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Endplate-specific fusion rate 1 year after surgery for two-level anterior cervical discectomy and fusion(ACDF)

  • Original Article - Spine degenerative
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Abstract

Study design

This is a retrospective study.

Objective

Implant nonfusion is an important prognostic factor for patients after anterior cervical discectomy and fusion (ACDF). This study aimed to investigate endplate-specific pseudarthrosis after ACDF, to determine if the rate of fusion is inferior in the lower endplate, and to identify any differences in clinical and radiological results.

Summary of background data

Research comparing each endplate on which the endplate affects nonfusion is limited.

Methods

We analyzed 71 patients with 142 total spinal levels who underwent double-level ACDF (C4-5-6 and C5-6-7) with an allograft and plate at our hospital between January 2012 and December 2018. Fusion grades were assessed using computed tomography and the Bridwell fusion grade system at 1 year postoperatively. Radiological parameters were obtained from lateral cervical radiographs collected preoperatively and at 1 month and 1 year after surgery.

Results

There was no difference in fusion between the C4-5-6 and C5-6-7 ACDF procedures, but the fusion rate and Bridwell fusion grade at the caudal surgery level were lower than those at the cranial surgery level (93 vs. 79%, p < 0.001). The lower endplate of the caudal fusion level showed the most common pseudarthrosis (18 of 71 [25%]). There was no difference in radiological parameters and clinical outcomes between the fusion and pseudarthrosis groups.

Conclusion

In double-level ACDF procedures, the nonfusion rate was higher at the caudal fusion levels, especially at the lower endplates of the caudal fusion levels.

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Authors and Affiliations

  1. Department of Neurosurgery, Spine and Spinal Cord Institute, Gangnam Severance Hospital, Yonsei University College of Medicine, 211 Eonju-ro, Dogok 1(il)-dong, Gangnam-gu, Seoul, 06273, Korea

    Hyun Jun Jang, Kyung Hyun Kim, Jeong Yoon Park, Keun Su Kim, Yong Eun Cho & Dong Kyu Chin

Authors
  1. Hyun Jun Jang
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  2. Kyung Hyun Kim
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  3. Jeong Yoon Park
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  4. Keun Su Kim
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  6. Dong Kyu Chin
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Corresponding author

Correspondence to Dong Kyu Chin.

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Ethics approval

This study was approved by the Institutional Review Board of Gangnam Severance Hospital (IRB No. 3–2021-0008).

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Not required because this study was a retrospective study.

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Not required because this study was a retrospective study.

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The authors declare no competing interests.

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Jang, H.J., Kim, K.H., Park, J.Y. et al. Endplate-specific fusion rate 1 year after surgery for two-level anterior cervical discectomy and fusion(ACDF). Acta Neurochir 164, 3173–3180 (2022). https://doi.org/10.1007/s00701-022-05377-6

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  • DOI: https://doi.org/10.1007/s00701-022-05377-6

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