ArticleActa neurochirurgica2022
Endplate-specific fusion rate 1 year after surgery for two-level anterior cervical discectomy and fusion(ACDF).
Article in Acta neurochirurgica, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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3 citing papers in PubMed.
- Biomechanical effects of supplemental posterior cervical stabilization in one-to three-level anterior cervical discectomy and fusion: a finite element analysis of construct length-dependent stress shielding and adjacent segment mechanics.Frontiers in bioengineering and biotechnology · 2026Article
- Surgical Outcomes of Craniocervical Junction Fractures in Elderly Patients: A Retrospective Single-Center Series.Journal of personalized medicine · 2025Article
- Treatment of the two-level degenerative cervical disk diseases based on algorithmic anterior approach: a multicenter prospective study.Neurosurgical review · 2023Article
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6 authors.
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Abstract
STUDY
designThis is a retrospective study.
objectiveImplant nonfusion is an important prognostic factor for patients after anterior cervical discectomy and fusion (ACDF). This study aimed to investigate endplate-specific pseudarthrosis after ACDF, to determine if the rate of fusion is inferior in the lower endplate, and to identify any differences in clinical and radiological results. Research comparing each endplate on which the endplate affects nonfusion is limited.
methodsWe analyzed 71 patients with 142 total spinal levels who underwent double-level ACDF (C4-5-6 and C5-6-7) with an allograft and plate at our hospital between January 2012 and December 2018. Fusion grades were assessed using computed tomography and the Bridwell fusion grade system at 1 year postoperatively. Radiological parameters were obtained from lateral cervical radiographs collected preoperatively and at 1 month and 1 year after surgery.
resultsThere was no difference in fusion between the C4-5-6 and C5-6-7 ACDF procedures, but the fusion rate and Bridwell fusion grade at the caudal surgery level were lower than those at the cranial surgery level (93 vs. 79%, p < 0.001). The lower endplate of the caudal fusion level showed the most common pseudarthrosis (18 of 71 [25%]). There was no difference in radiological parameters and clinical outcomes between the fusion and pseudarthrosis groups.
conclusionIn double-level ACDF procedures, the nonfusion rate was higher at the caudal fusion levels, especially at the lower endplates of the caudal fusion levels.
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