MICROSURGICAL ANTERIOR DECOMPRESSION AND INTERNAL-FIXATION WITH ILIACBONE-GRAFT AND TITANIUM PLATES FOR TREATMENT OF CERVICAL INTERVERTEBRAL DISC HERNIATION

42 cervical interbody fusions with iliac bone graft and titanium plate fixation were performed between October 1991 and March 1994. The mean follow up period in this study was 10.7 months. In 32 cases fusion wa s done for 1 and in 10 cases for 2 segments. 2 different types of plat es were used. In 25 cases micro-osteosynthesis plates and screws with 2.7 mm diameter were used, and in 17 cases cervical H-plates and screw s with 3.5 mm diameter. A favourable outcome was achieved in 31 of 42 cases (74%). Satisfactory pain relief was achieved in 90%. For radicul ar motor deficit good results were obtained in 84% and for cervical my elopathy in 54%. The 2 different types of plates showed a remarkable d ifference in the clinical outcome. The results were regarded favourabl e in 15 of 25 microplate fusions (60%) and in 16 of 17 H-plate fusions (94%). Compression of the bone graft was seen in 5 patients of the mi cro plate group, however, radiological signs for fusion were present i n all 42 cases al follow up. Major surgical complications, damage to n eural structures or neurological deterioration did not occur in this s tudy. Plate fixation in cervical interbody fusions seems to be a safe procedure and may reduce graft related complications at the fusion sit e if the plates and screws are sufficiently well proportioned. A favou rable impact upon the results for cervical interbody fusion might be e xpected and should be further investigated in a long term follow up st udy.