Original ArticlesA Prospective Comparison of the Standard and Reverse Robinson Cervical Grafting Techniques: Radiographic and Clinical AnalysesJenis, Louis G.; An, Howard S.*; Simpson, J. Michael†Author Information Department of Orthopaedic Surgery, New England Baptist Hospital, Boston, Massachusetts; *Department of Orthopedic Surgery, Rush-Presbyterian-St. Luke's Medical Center, Chicago, Illinois; and †Orthopaedic Associates, Ltd., Glen Allen, Virginia, U.S.A. Received November 16, 1999; accepted March 1, 2000. Address correspondence and reprints requests to Dr. L. G. Jenis, New England Baptist Hospital, 125 Parker Hill Avenue, Boston, MA 02120, U.S.A. E-mail: Ljenis@NEBH.org Journal of Spinal Disorders: October 2000 - Volume 13 - Issue 5 - p 369-373 Buy Abstract The authors performed a prospective study of 63 patients with cervical radiculopathy treated with Robinson anterior cervical discectomy and fusion and compared the traditional or standard and reverse graft techniques. Modifications of the standard Robinson grafting techniques have been proposed. The reverse graft technique has theoretical advantages, including limiting the deleterious effects of graft extrusion and maintaining rigid middle column support. A radiographic evaluation and an assessment of clinical outcome based on the criteria of Odom were performed prospectively for as long as 1 year after surgery. Thirty-one patients were treated with the standard grafting technique and 32 with the reverse graft orientation. The radiographic evaluation showed no significant differences between the two techniques with regard to sagittal alignment and disk heights. The overall fusion grade was higher in the reverse graft technique (p < 0.05). There were 93% and 96% good to excellent results in the standard graft and reverse graft groups, respectively. The authors report no significant differences associated with the standard or reverse anterior cervical grafting techniques in terms of radiographic alignment or disk height loss over time or at early clinical outcome. However, improved fusion grade was noted with the reverse graft technique, which may be related to end plate and intervertebral space preparation. The reverse grafting technique is an acceptable alternative to the standard graft orientation. © 2000 Lippincott Williams & Wilkins, Inc.