Anterior cervical fusion and trapezoidal plate stabilization for re-do surgery

BACKGROUND Pseudarthrosis, graft fracture or dislocation, and kyphotic angulations are highly undesired complications after surgery of the cervical spine. The purpose of this retrospective study was to evaluate the effect of anterior cervical fusion and plating in cases of failed cervical spine surgery. METHODS From January 1980 to December 1993 41 patients (25 male, 16 female, mean age 46.8 years, range 30-66 years) underwent corrective surgery of the cervical spine in our department. A total of 33 patients had one, 7 patients had two, and one patient had three previous cervical operations. Re-do surgery was most frequently indicated because of intractable head-neck-shoulder-arm-pain corresponding with radiological findings. Corrective surgery consisted of anterior cervical decompression, realignment, autologous iliac crest bone graft fusion, and trapezoidal plate stabilization. Clinical and radiological follow-up examinations were performed, ranging from 20 to 112 months with a mean of 24.7 months, in 37 patients. Epidemiological, clinical, and radiological data were collected and used for this retrospective study. RESULTS Of 37 patients 21 showed complete alleviation of head-neck-shoulder pain, 10 improved, and six remained unchanged. Of 15 myelopathy patients, one showed further progress, two were unchanged, four were normal, and eight showed only mild signs of medullary irritation, e.g., hyperreflexia or minimal spasticity. Radiological examinations showed a stable bony fusion in optimal alignment in all 37 patients. CONCLUSION Based on these findings, anterior cervical decompression, fusion, and plating is a rational treatment in cases of failed cervical fusion. (C) 1999 by Elsevier Science Inc.