There are various methods of grafting for anterior cervical fusion. The most important thing for spinal fusion is to achieve decompression of the neural structure, reconstruction of stability, and physiological alignment of the cervical spine. Anterior cervical fusion with hydroxyapatite graft is gaining popularity in the management of degenerative cervical spine disease because this material has excellent bioactivity and biocompatibility, and makes it possible for patients to avoid the donor site problem. We have used three types of hydroxyapatite graft in 72 cases in the past 4 years. The underlying primary pathological conditions included disc extrusion, spondylosis, ossification and/or hypertrophy of the posterior longitudinal ligament, and epiphyseal dysplasia. No neurological deterioration related to the surgical procedure has been encountered. However, dislocation and collapse of the graft occurred in three patients who needed reoperation. Dislocation occurred in two patients who could not remain at rest after surgery, and we think it was caused because we did not make the embankment on the posterior portion of their vertebral bodies. Collapse occurred in one patient due to the fragility of the porous hydroxyapatite material with 42% porosity. Since then, we have used denser hydroxyapatite graft and have never experienced collapse of the graft. We would like to say that anterior cervical fusion with hydroxyapatite graft is one of the useful procedures for keeping good and precise fusion without donor site problem. Moreover, we intend to continue to follow up long-term postoperative results and to make efforts to devise the best procedure for patients.
