Anterior cervical fusion using vertical self-locking T-graft.

Ninety-three patients with persistent signs and symptoms of cervical disk disorder resistant to conservative therapy were treated surgically by anterior cervical diskectomy and fusion with a vertical self-locking T-graft. This surgical technique offers the following mechanical and physiological advantages: the load-bearing capability of the cortices of the vertical graft supports the cortices of the adjacent vertebral bodies, and prevents anterior wedging postoperative structural collapse; the surgical removal of the cartilaginous end plate and intimate relation between the cancellous bone of the graft and the vertebrae promotes early fusion; the posteriorly positioned prongs of the graft present extrusion; the posterior cortex and posterior longitudinal ligament are not removed, thus minimizing the spinal cord injuries. In a two- to ten-year follow-up, 90% of the patients obtained an excellent of good result. Those with a single level of fusion obtained a far better end result. Complications among these 93 patients were relatively minimal: no instance of anterior collapse or wedging, no evidence of extrusion, no wound or disk space infection, and no neurologic complications occurred. The author recommends this approach when managing selected patients.