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Corresponding author: Dong Ah Shin Department of Neurosurgery, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea Tel: +82-2-2228-2150 Fax: +82-2-393-9979 E-mail: shindongah@me.com Objective: To analyze the surgical outcomes of patients who underwent 1-level, 2-level, and 3-level anterior cervical discectomy and fusion (ACDF). Methods: We retrospectively assessed 182 patients with symptomatic cervical degenerative disease who underwent ACDF with allograft and a plate at our institution between January 2012 and March 2014. After only including patients with a >24 month follow-up, 142 fulfilled our inclusion criteria (71 underwent 1-level, 46 underwent 2level, and 25 underwent 3-level ACDF). The assessment tools included the Short Form-36 (SF-36), Neck Disability Index (NDI), and visual analog scale (VAS). The fusion status was measured by radiography at 24 months postoperatively. Statistical analyses were performed with SPSS version 20.0. Results: The fusion rate was 84% in the 3-level group, 98.6% in the 1-level group, and 97.8% in the 2-level (p=0.017). There was a significant difference between 2-level vs. 3-level ACDF (p=0.049). Complications occurred in 4 (16%) patients of the 3-level group, 2 (2.8%) patients of the 1-level group, and 1 (2.2%) patient of the 2-level group (p=0.030). The subsidence rate was significantly higher in the 3-level group than in the other 2 groups (52%, p=0.047). Significant differences were observed between groups in terms of the NDI and SF-36 at the last follow-up (p=0.040 and p=0.046, respectively). Conclusion: The surgical outcome of the 3-level ACDF group was worse than that of the 1level or 2-level ACDF groups, which was indicated by the lower fusion rate, higher complication rate, and higher subsidence rate.

Analysis of Surgical Results According to the Number of Fused Levels in Anterior Cervical Discectomy and Fusion: A Retrospective Study