This single-surgeon retrospective study evaluates long-term outcomes of the Robinson ACDF technique in 122 patients with cervical radiculopathy. The Robinson method uses anterior discectomy with tricortical iliac-crest graft — without osteophyte removal — across 1 to 4 levels. Mean follow-up was 6 years (range 2-15 years).
The 93% good-to-excellent result from this series established the outcomes benchmark that still anchors pre-operative ACDF counseling today.
When a patient with cervical radiculopathy fails conservative management (average 9 months in this cohort), ACDF can be offered with confidence: pain relief is highly predictable, motor deficits almost universally recover, and the risk of neurological worsening is negligible.
When planning multilevel ACDF, flag the significantly higher pseudarthrosis risk upfront (p < 0.01 vs. Single-level). Bohlman subsequently modified his technique — burring endplates to expose bleeding subchondral bone rather than simple puncture holes. To improve fusion rates in multilevel cases.
Use flexion-extension radiographs, not static lateral films alone, to confirm fusion. This paper documented pseudarthroses that appeared solid on standard views, underscoring that dynamic imaging is required for accurate assessment.
This single-surgeon retrospective study evaluates long-term outcomes of the Robinson ACDF technique in 122 patients with cervical radiculopathy. The Robinson method uses anterior discectomy with tricortical iliac-crest graft — without osteophyte removal — across 1 to 4 levels. Mean follow-up was 6 years (range 2-15 years).
The 93% good-to-excellent result from this series established the outcomes benchmark that still anchors pre-operative ACDF counseling today.
When a patient with cervical radiculopathy fails conservative management (average 9 months in this cohort), ACDF can be offered with confidence: pain relief is highly predictable, motor deficits almost universally recover, and the risk of neurological worsening is negligible.
When planning multilevel ACDF, flag the significantly higher pseudarthrosis risk upfront (p < 0.01 vs. Single-level). Bohlman subsequently modified his technique — burring endplates to expose bleeding subchondral bone rather than simple puncture holes. To improve fusion rates in multilevel cases.
Use flexion-extension radiographs, not static lateral films alone, to confirm fusion. This paper documented pseudarthroses that appeared solid on standard views, underscoring that dynamic imaging is required for accurate assessment.