Anterior cervical discectomy and fusion (ACDF) procedures have been performed for
over 50 years. While complications are minimal and results are generally good, the
most common complication is nonunion. Various approaches to repair these nonunions
have been suggested. Anterior revision surgery results in a fusion in up to 97% of
patients with minimal to no complications. Posterior revision surgery produces up
to 100% fusion rates with a similar minimal complication occurrence. Some support
exists for combined anterior/posterior approach with 100% fusion rate and no complications.
No large multicenter randomized prospective study provides definitive evidence to
support one approach over another.
Anterior cervical discectomy - revision - failure