A prospective study of anterior cervical spondylodesis in intervertebral disc disorders.

In 1977, a prospective study of anterior cervical fusion was started in cases of intervertebral disc disorders with neuropathy and/or myelopathy up to 1986. A total of 193 patients was operated upon, of whom 179 were available for this study, with a mean follow-up time of 10.4 years (6-14 years) and a mean age of 51 years (28-76). There was an extensive record for every patient according to the protocol. The indication for operation was decided upon by an orthopaedic surgeon and a neurologist and was defined as discopathy with progressive neurological disorders, which did not respond to conservative therapy. The wearing of a stiff collar for 6 weeks during which time there was a improvement of the neurological symptoms was a strict precondition for the operation. Up to 5 levels were fused, with a mean of 2.3 levels per patient. During the operation a discography was performed on the symptomatic level(s) and the adjacent levels. All levels with positive discopathy were fused. In this long-term study the overall percentage of excellent and good results was about 82%. The results of fusions involving more than two levels were very encouraging.