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Is There a Gold Standard for Cervical Fusion?

Chronic neck (cervical) pain from degenerative disc disease (DDD) is sometimes treated with an operation to fuse the bones together. First the damaged disc is removed, and then the bones are fused. This is called an interbody fusion. The best way to fuse the cervical spine remains under investigation.

In this study 100 patients with 127 cervical levels of DDD were treated and followed for at least 12 months. Patients were divided into two groups. Group 1 (the ICAG fusion group) had a fusion using bone graft taken from the iliac (pelvic) crest.

Group 2 (the RTC group) had a rectangular titanium cage inserted in place of the disc. Usually the cages are filled with bone chips or other material. In this study the cages were left empty.

The results of this study showed that both fusion methods are safe and effective. Both had equally good results with one exception. The ICAG group had more overall pain at the neck and at the donor site. Neck and arm pain were better in the RTC group but neck pain didn't go away for one-third of the RTC group. The RTC group had no donor site so their overall pain was less making this method slightly more advantageous for the patient.

References: Claudius Thomé, MD, et al. A Prospective Randomized Comparison of Rectangular Titanium Cage Fusion and Iliac Crest Autograft Fusion in Patients Undergoing Anterior Cervical Discectomy. In Journal of Neurosurgery: Spine. January 2006. Vol. 4. No. 1. Pp. 1-9.

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