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In Fusion Necessary After Anterior Cervical Discectomy?

Klara, Peter, MD, PHD

Section Editor(s): McLain, Robert F. MD; Boden, Scott D. MD

Controversy in Spine Care

Anterior cervical discectomy is an effective and reliable treatment for nerve root or cord compression caused by disc herniation or spondylosis. Although physicians have traditionally included fusion as a part of this procedure, recent experience has suggested that this may not be necessary. Dr. Volker Sonntag and Dr. Peter Klara express opposing views on the need for fusion after discectomy and support their perspectives with clinical experience and a review of the pathoanatomy of disc disease. Dr. Sonntag believes that the majority of patients are well served with discectomy alone, avoiding the complications of graft harvest and potential nonunion. Dr. Klara feels that the interposed graft restores foraminal height and maintains cervical lordosis, both of which are important to a good outcome.

Associate Editors; Controversy

Address correspondence to: Robert F. McLain; Department of Orthopaedic Surgery; University of California-Davis; 2230 Stockton Boulevard; Sacramento, CA 95817

Norfolk, Virginia

Acknowledgment date: October 16, 1995.

First revision date: December 1, 1995.

Acceptance date: December 5, 1995.

Device status category: 1.

© 1996 by Lippincott Williams & Wilkins