We evaluated the results of the Robinson method of anterior cervical discectomy and arthrodesis with use of autogenous iliac-crest bone graft, at one to 4 levels, in 122 patients who had cervical radiculopathy. A one-level procedure was done in 62 of the 122 patients; a 2-level procedure, in 48; a 3-level procedure, in 11; and a 4-level procedure, in one. The average duration of clinical and roentgenographic follow-up was 6 years (range, 2 to 15 years). The average age was 50 years (range, 25 to 78 years). Preoperatively, 118 patients had pain in the arm, 55 had weakness of one or more motor roots, and 77 had sensory loss. At the time of follow-up, 81 patients had no pain in the neck, 26 had mild pain in the neck, 9 had moderate pain in the neck, 4 had mild radicular pain, and 2 had a combination of mild radicular pain and moderate pain in the neck. 108 patients had no functional impairment, and 14 had a slight limitation of function during the activities of daily living. 9 of 11 patients who had symptoms related to a change at one level cephalad or caudad to the site of a previous arthrodesis had another operative procedure. Lateral roentgenograms of the cervical spine, made in flexion and extension, showed a pseudarthrosis at 24 of 195 operatively treated segments. 16 of the patients who had a pseudarthrosis were symptomatic, but only 4 had sufficient pain to warrant revision. The risk of pseudarthrosis was significantly greater after a multiple-level arthrodesis than after a single-level arthrodesis (p < 0.01). At the time of the most recent follow-up, 53 of the 55 patients who had had a motor deficit had had a complete recovery, and the 2 remaining patients had had a partial recovery. 71 of the 77 patients who had had a sensory loss had regained sensation. None of the patients had an increased neurological deficit postoperatively. Our results suggest that the Robinson anterior cervical discectomy and arthrodesis with an autogenous iliac-crest bone graft for cervical radiculopathy is a safe procedure that can relieve pain and lead to resolution of neurological deficits in a high percentage of patients.
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We evaluated the results of the Robinson method of anterior cervical discectomy and arthrodesis with use of autogenous iliac-crest bone graft, at one to 4 levels, in 122 patients who had cervical radiculopathy. A one-level procedure was done in 62 of the 122 patients; a 2-level procedure, in 48; a 3-level procedure, in 11; and a 4-level procedure, in one. The average duration of clinical and roentgenographic follow-up was 6 years (range, 2 to 15 years). The average age was 50 years (range, 25 to 78 years). Preoperatively, 118 patients had pain in the arm, 55 had weakness of one or more motor roots, and 77 had sensory loss. At the time of follow-up, 81 patients had no pain in the neck, 26 had mild pain in the neck, 9 had moderate pain in the neck, 4 had mild radicular pain, and 2 had a combination of mild radicular pain and moderate pain in the neck. 108 patients had no functional impairment, and 14 had a slight limitation of function during the activities of daily living. 9 of 11 patients who had symptoms related to a change at one level cephalad or caudad to the site of a previous arthrodesis had another operative procedure. Lateral roentgenograms of the cervical spine, made in flexion and extension, showed a pseudarthrosis at 24 of 195 operatively treated segments. 16 of the patients who had a pseudarthrosis were symptomatic, but only 4 had sufficient pain to warrant revision. The risk of pseudarthrosis was significantly greater after a multiple-level arthrodesis than after a single-level arthrodesis (p < 0.01). At the time of the most recent follow-up, 53 of the 55 patients who had had a motor deficit had had a complete recovery, and the 2 remaining patients had had a partial recovery. 71 of the 77 patients who had had a sensory loss had regained sensation. None of the patients had an increased neurological deficit postoperatively. Our results suggest that the Robinson anterior cervical discectomy and arthrodesis with an autogenous iliac-crest bone graft for cervical radiculopathy is a safe procedure that can relieve pain and lead to resolution of neurological deficits in a high percentage of patients.
Copyright remains with the authors and publisher.