Clinical and Radiographic Outcomes Following Anterior Cervical Discectomy and Fusion Using Integrated Anchor Fixation – A Single-Centre Experiences

Open Access

Abstract

Background: Anterior cervical discectomy and fusion (ACDF) is a widely accepted surgical intervention for cervical degenerative disc disease. Integrated anchor fixation systems have emerged as an alternative to traditional anterior plating, offering reduced soft tissue disruption and lower complication rates while maintaining biomechanical stability. Aim of the study: To evaluate the clinical and radiographic outcomes, fusion rates, and complication profiles following ACDF using an integrated anchor fixation system in patients with symptomatic cervical degenerative disc disease. Methods & Materials: This prospective observational study included 60 patients who underwent ACDF with an integrated anchor fixation device at a single tertiary center. Preoperative and 12-month postoperative outcomes were assessed using the Visual Analog Scale (VAS) for neck and arm pain, Neck Disability Index (NDI), and SF-36 Physical and Mental Component Scores. Radiographic parameters included segmental and global cervical lordosis, disc height, fusion status, and cage subsidence. Subgroup analysis was conducted between single- and two-level procedures. Result: Significant improvements were observed in all clinical metrics at 12 months: VAS-neck decreased from 7.9 ± 1.2 to 2.3 ± 1.1 (p < 0.001), VAS-arm from 7.3 ± 1.3 to 1.9 ± 1.2 (p < 0.001), and NDI from 53.2 ± 8.6% to 16.1 ± 6.3% (p < 0.001). SF-36 PCS and MCS improved by 17.2 and 16.2 points, respectively (p < 0.001). Radiographic analysis showed significant gains in segmental lordosis (2.1° to 6.0°, p < 0.001) and disc height (4.3 mm to 6.3 mm, p < 0.001). Fusion was achieved in 95% of cases. Subsidence (>2 mm) occurred in 8.3%, and dysphagia was reported in 11.7% at one month. Two-level ACDF cases had lower fusion rates (83.3% vs. 97.8%, p = 0.045) and higher dysphagia incidence (33.3% vs. 6.7%, p = 0.023) compared to single-level cases. Conclusion: ACDF with integrated anchor fixation resulted in substantial improvements in pain, function, and radiographic alignment, with high fusion rates and a low incidence of complications. These findings support the use of integrated fixation as a safe and effective alternative to traditional anterior plating, particularly in single-level procedures.