Treatment Options for Failure of Anterior Cervical Discectomy and Fusion

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