Prospective study of clinical and radiological outcome after anterior cervical discectomy

Most surgeons undertaking anterior cervical discectomy (ACD) introduce a bone graft or cage into the disc space when the decompression is complete to prevent segmental collapse and preserve cervical spine alignment. We have conducted a prospective observational cohort study to investigate the relationship 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 the operated level were correlated with clinical outcome measured by SF 36, Neck Disability Index and visual analogue neck pain score. Loss of the overall cervical lordosis was present in 30 patients and segmental kyphosis was found in 18. Analysis of clinical outcome showed no statistical differences between patients with preserved and abnormal cervical and segmental alignment. Disturbance of cervical and segmental alignment is common in patients following cervical discectomy, but does not appear to compromise clinical outcome at 12 months.