THE LONG-TERM CLINICAL OUTCOME OF PATIENTS UNDERGOING ANTERIOR CERVICAL DISKECTOMY WITH AND WITHOUT INTERVERTEBRAL BONE-GRAFT PLACEMENT

OBJECTIVE: This retrospective study provides data on the long-term cli nical outcomes of patients with either anterior cervical discectomy al one (ACD) or anterior cervical discectomy with intervertebral bone gra ft placement (ACDF). METHODS: A questionnaire was mailed to 525 patien ts who had undergone ACD (290 patients) or ACDF (235 patients) at leas t 2 years previously. All procedures were performed by University of N ebraska Medical Center faculty in the Section of Neurosurgery. The fol low-up period averaged 8.1 years, with a range of 2 to 14 years. RESUL TS: Two hundred sixty-two (49.9%) patients responded to the questionna ire. There was no demographic difference between respondents and nonre spondents (P > 0.05). Respondents who underwent ACDF reported fewer pr oblems with pain than did those who underwent ACD (P < 0.05). A higher percentage of respondents with ACDF reported that they had normal fun ction than did those who underwent ACD (P < 0.05). When limited to res pondents who underwent first-time, single-level operations (191 patien ts), similar results were obtained for the pain parameter (P < 0.05) b ut not for the level of function (P = 0.25). Patients with longer foll ow-up periods had fewer problems with pain and better levels of functi on (P < 0.05). CONCLUSION: Patients who underwent ACD or ACDF did well and benefited from their operations. Those who underwent ACDF did bet ter than those who underwent ACD. Length of follow-up was also an impo rtant predictor of current levels of function and pain.