Purpose
A retrospective study to compare the radiologic and clinical outcomes of 2 different anterior approaches, multilevel
anterior cervical discectomy with fusion (ACDF) using autologus ticortical bone graft versus anterior cervical corpectomy
with fusion (ACCF) using free vascularized fibular graft (FVFG) for the management of cervical spondylotic
myelopathy(CSM).
Methods
A total of 15 patients who underwent ACDF or ACCF using FVFG for multilevel CSM were divided into two
groups. Group A (n = 7) underwent ACDF and group B (n = 8) ACCF. Clinical outcomes using Japanese Orthopaedic
Association ( JOA) score, perioperative parameters including operation time and hospital stay, radiological
parameters including fusion rate and cervical lordosis, and complications were compared.
Results
Both group A and group B demonstrated significant increases in JOA scores. Patients who underwent ACDF experienced
significantly shorter operation times and hospital stay. Both groups showed significant increases in postoperative
cervical lordosis and achieved the same fusion rate (100 %). No major complications were encountered in
both groups.
Conclusion
Both ACDF and ACCF using FVFG provide satisfactory clinical outcomes and fusion rates for multilevel CSM.
However, multilevel ACDF is associated with better radiologic parameters, shorter hospital stay and shorter operative
times.