Results of Posterior Neck Fusion After Anterior Neck Fusion

Surgeons at the UCLA School of Medicine report on 33 patients who had a failed anterior cervical (neck) fusion. Movement at the fusion site called pseudoarthrosis caused continued neck and arm pain. They all had a second operation to fuse the same level from the back (posterior). Reported results of this treatment for pseudoarthrosis are few and far between.

The first operation done was called an anterior cervical discectomy and fusion (ACDF). The disc was removed and bone graft used to fuse the spine. Motion of the facet joints at one or two levels (seen on X-rays) showed the pseudoarthrosis.

After the posterior operation the authors report a solid fusion in all 33 patients. Everyone had some improvement in his or her painful symptoms. But about half the patients still had pain. Almost one-third of that group reported severe pain.

The authors say the debate goes on about which is better: anterior versus posterior revision fusion. Theirs is the largest study done so far using posterior fusion after ACDF. Although the fusion was successful, patients didn't always get the pain relief desired.