A meta-analysis of autograft versus allograft in anterior cervical fusion

We performed a metaanalysis of one- and two-level anterior cervical interbo dy fusion (ACDF) on data derived from published, peer-reviewed journal arti cles to determine whether there is a difference in fusion rate, graft compl ications, or clinical outcome in patients undergoing ACDF according to whet her autograft or allograft was used. ACDF is a common procedure for cervica l spondylotic radiculopathy. Most published studies comparing autograft and allograft have not demonstrated any difference between grafts. The medical literature dating from 1955 was reviewed. Of 395 titles, only four studies comparing autograft with allograft in ACDF were appropriate for this analy sis. The data from these studies - 310 patients and 379 intervertebral leve ls were pooled and statistical methods were applied. For both one- and two- level ACDF, autograft demonstrated a higher rate of radiographic union and a lower incidence of graft collapse. It was not possible to ascertain wheth er autograft is clinically superior to allograft. Although autograft has a higher fusion rate than allograft, clinical results do not depend solely on radiographic results. The risk of graft site morbidity and patient prefere nce should be considered when choosing the type of graft for this operation .