Three-levels anterior cervical discectomy and fusion using titanium cages without plates were performed for five patients (4 male and 1 female). Mean age of the patients was 55 years (range : 34-62 years) with a mean follow-up interval of 21 months (range : 8-30 months). Three-levels anterior fusion was performed for cervical kyphosis, 3 level radiculopathy, and asymptomatic adjacent disc hernia or osteophyte. Of the 15 levels involved, 13 showed a stable fixation, in which 10 had bony fusion. Patients recovered significantly (p=0.009), by which mean NCSS scores were 11.4 and 13.2 pre-and postoperatively. Preoperative mean cervical lordosis C2-7 and range of motion (ROM) were 5.6° and 28.8° respectively, and postoperative mean lordosis and ROM were 14.4° and 19.8° respectively. There were no significant changes in these two parameters. There was no postoperative complications.
As compared with the cervical laminoplasty group (24 patients, 23 males and 1 female, mean age 57 years), there were no significant differences in the pre-and postoperative NCSS scores, cervical lordosis, and ROM. In the laminoplasty group, however, there was transient C5 and C7 palsy.
Neurological status, neuroradiological findings, and general condition of the patient should all be considered carefully, when three-level cervical anterior decompression and fusion is performed.