Patients with serious degenerative spinal disease, a painful condition in which the normal function of spinal vertebrae breaks down, are presented with what can be a confusing array of surgical options. A NewYork-Presbyterian Hospital/Weill Cornell Medical Center study looks at five spinal fusion approaches.

Spinal fusion is a "welding" process by which two or more of the vertebrae that make up the spinal column are fused together to heal into a single solid bone. The surgery eliminates motion between vertebrae segments, which may be desirable when motion is the cause of significant pain.

Investigators performed a meta-analysis of studies involving a total of 2,682 cases treated with five spinal fusion procedures: anterior cervical discectomy (ACD); ACDF (ACD and interbody fusion); ACDFP (ACDF and placement of an anterior plate); vertebral corpectomy; and corpectomy with placement of an anterior plate. All procedures involve a removal of the diseased disc; some involve the removal of part of the vertebra (corpectomy) and/or the placement of a stabilizing plate.

For single-disc-level procedures, the most common, the fusion rate was 97.1 percent (329 cases) for ACDFP, compared to 84.9 percent (1,134 cases) for ACD and 92.1 percent (62 cases) for ACDF.

The study also found that for two-disc-level disease, there was no significant difference between ACD with a plate system or corpectomy with a plate system. For three-disc-level disease, however, the evidence suggests that corpectomy with plate placement is associated with higher fusion rates than discectomy with plate placement (ACDFP).; Source: NewYork-Presbyterian Hospital