Most surgeons undertaking anterior cervical discectomy (ACD) introduce a bo
ne graft or cage into the disc space when the decompression is complete to
prevent segmental collapse and preserve cervical spine alignment. We have c
onducted a prospective observational cohort study to investigate the relati
onship between cervical spine alignment and clinical outcome in 55 patients
undergoing ACD without interbody graft or cage. At 12 months, the overall
alignment of the cervical spine and the presence of segmental kyphosis at t
he operated level were correlated with clinical outcome measured by SF 36,
Neck Disability Index and visual analogue neck pain score. Loss of the over
all cervical lordosis was present in 30 patients and segmental kyphosis was
found in 18. Analysis of clinical outcome showed no statistical difference
s between patients with preserved and abnormal cervical and segmental align
ment. Disturbance of cervical and segmental alignment is common in patients
following cervical discectomy, but does not appear to compromise clinical
outcome at 12 months.