Twenty-Year Radiographic Outcomes Following Single-Level… : Spine
nterior cervical discectomy and fusion is the standard of treatment for single-level cervical disc degeneration causing radiculopathy. CDA is claimed to reduce shear strain, and adjacent-level ROM changes are hypothesized to hasten ASD with ACDF. Materials and Methods. This study collected data on 47 patients randomized to ACDF or CDA. Lateral cervical spine radiographs were evaluated preoperatively, postoperatively, and at 20 years for alignment, ROM, ASD, and heterotopic ossification. Results. Eighty-two percent (18/22) of CDA patients and 84% (21/25) of ACDF patients followed up at 20 years. At 20 years, total cervical (C2–C7) ROM was statistically different between the CDA and fusion groups (47.8° vs. 33.4°, P=0.005). Total cervical ROM was not significantly different between preoperative and 20-year periods following CDA (45.6° vs. 47.4°, P=0.772) or ACDF (40.6° vs. 33.0°, P=0.192). Differences in postoperative and 20-year index-level ROM following CDA were not significant (10.1°