The arthrodesis rate in multilevel anterior cervical fusions using autogenous fibula

STUDY DESIGN: This study was a roentgenographic review of 145 patients who underwent multilevel anterior cervical arthrodesis using autogenous fibula. OBJECTIVE: To determine the arthrodesis rate in multilevel cervical fusions using autogenous fibula. SUMMARY OF BACKGROUND DATA: Previous studies have shown an unacceptably high rate of nonunions with multilevel anterior cervical arthrodesis. However, this has not been the clinical experience of the author's group. METHODS: Lateral roentgenograms taken a minimum of 2 years after surgery were reviewed independently by two radiologists. If either radiologist questioned any fusion level, the final decision was made on the basis of flexion-extension roentgenograms. RESULTS: An overall union rate of 90% and 94% per patient was found for each level of attempted fusion. A solid arthrodesis was achieved in 93% of the patients with two-level fusions, and 84% of the three-level fusions were solid. The difference was not statistically significant. CONCLUSION: Autogenous fibula used as a strut graft results in an acceptable union rate for multilevel anterior cervical arthrodesis.