BACKGROUND
Pseudarthrosis, graft fracture or dislocation, and kyphotic angulations are
highly undesired complications after surgery of the cervical spine. The pu
rpose of this retrospective study was to evaluate the effect of anterior ce
rvical fusion and plating in cases of failed cervical spine surgery.
METHODS
From January 1980 to December 1993 41 patients (25 male, 16 female, mean ag
e 46.8 years, range 30-66 years) underwent corrective surgery of the cervic
al spine in our department. A total of 33 patients had one, 7 patients had
two, and one patient had three previous cervical operations. Re-do surgery
was most frequently indicated because of intractable head-neck-shoulder-arm
-pain corresponding with radiological findings. Corrective surgery consiste
d of anterior cervical decompression, realignment, autologous iliac crest b
one graft fusion, and trapezoidal plate stabilization. Clinical and radiolo
gical follow-up examinations were performed, ranging from 20 to 112 months
with a mean of 24.7 months, in 37 patients. Epidemiological, clinical, and
radiological data were collected and used for this retrospective study.
RESULTS
Of 37 patients 21 showed complete alleviation of head-neck-shoulder pain, 1
0 improved, and six remained unchanged. Of 15 myelopathy patients, one show
ed further progress, two were unchanged, four were normal, and eight showed
only mild signs of medullary irritation, e.g., hyperreflexia or minimal sp
asticity. Radiological examinations showed a stable bony fusion in optimal
alignment in all 37 patients.
CONCLUSION
Based on these findings, anterior cervical decompression, fusion, and plati
ng is a rational treatment in cases of failed cervical fusion. (C) 1999 by
Elsevier Science Inc.