Ventral Discectomy With PMMA Interbody Fusion for Cervical Disc Disease

STUDY DESIGN: Retrospective study of patients who underwent ventral discectomy and polymethyl-methacrylate (PMMA) interbody fusion for cervical radiculopathy. OBJECTIVES: To evaluate the long-term outcome after ventral discectomy and PMMA interbody fusion and to compare it with previous data from other surgical techniques for the treatment of cervical radiculopathy. SUMMARY OF BACKGROUND DATA: Because PMMA interbody fusion after ventral discectomy does not result in solid bony fusion in all cases, a good long-term outcome using this surgical technique has been questioned. METHODS: Long-term follow-up evaluation after surgery was performed in 249 patients (96 women and 153 men) with radicular signs only. The mean age was 46.0 +/- 8.7 years (range, 24-74 years), and the observation time ranged from 10-15 years (mean, 12.2 +/- 1.2 years). Clinical grading after surgery according to Odom's criteria was based on a questionnaire. The outcome was related to morphologic findings, lumbar symptoms, physical stress, duration of symptoms, age, sex, and cervical level involved. RESULTS: Complications related to surgery occurred in 13 (5.2%) patients, but only three (1.2%) had persistent problems. Of the 249 patients, 101 (40.6%) were without any symptoms (Odom I), 92 (36.9%) had a good outcome (Odom II), and 47 (18.9%) a fair outcome (Odom III). Only nine patients (3.6%) reported an unchanged or worse status than before surgery (Odom IV). Additional lumbar symptoms, high occupational physical stress, and discrepancy of preoperative findings were significantly correlated with a worse outcome. Short duration of symptoms and soft disc disease were favorable prognostic factors. CONCLUSIONS: PMMA interbody fusion after ventral discectomy in cervical disc surgery is a safe and reliable method with few complications and an outcome comparable with other ventral procedures.