Background:

            Anterior cervical discectomy and fusion (ACDF) with or without instrumentation is a surgical procedure performed to remove a herniated cervical disc which has an irritative and compressive effect on the neural elements, producing features of discogenic neck pain, radiculopathy, or myelopathy. Anterior cervical discectomy has proven to be a safe and effective procedure for the treatment of degenerative disc disease. Some surgeons perform simple discectomy without the addition of a fusion procedure. Possibility of developing late kyphosis from disc space collapse was a major drawback that needs a solution. Several techniques of anterior cervical inter body fusion have been described, though the approach is same but technique is different. The two common techniques used in Anterior cervical discectomy either to use artificial cage only or to add plates with cages with different results between the two techniques.

Objective:

            Comparing the differences between the plating system and the non -plating system in patients with symptomatic cervical disc herniation, regarding pain and functional outcome.

Study design:

            A retrospective study was applied on twenty patients with symptomatic cervical disc herniation in Sohag university hospital between September 2014 and September 2016. Half of patients were treated with ACDF (anterior cervical discectomy with fusion) by artificial cage only and another half with ACDF plus plating.        

Results:

            Both groups were compared regarding pain scales, graft subsidence and neck lordosis. Patient’s age ranged from 24 years to 65 years. There were 12 (60%) male patients and 8 (40%) female patients. On admission, 12 (60%) patients complained of cervical radiculopathy, 4 (20%) had myelopathy, and 4 (20%) had myelopathy associated with radiculopathy. Of the twenty patients, eight had 3 level affected, six with two level affected, and the remaining six patients with one level cervical disc prolapse.

Conclusion:

            Although plate-assisted cervical fusion has the drawbacks of high cost, a long operative time, and risk of injury to adjacent structures because of the retraction required for plate insertion, but the incidence of postoperative complication rate is relatively low and most symptoms were improved as time goes. Plate-assisted cervical fusion group can prevent cage subsidence and cervical kyphosis.