Spinal Bone Autograft for C3-C4 ACDF

Evidence Supporting Autograft Use in ACDF

Autograft bone harvested from the iliac crest has been successful in creating arthrodesis after 1-level anterior cervical discectomy and fusion with Class II evidence supporting its efficacy 1, 3
Multiple strategies for interbody grafting have been successful, but autograft has yielded higher fusion rates in both 1- and 2-level procedures compared to alternatives 2, 4
Autograft provides a physiologically dynamic support system that both protects neural structures and decreases mechanical pain through mature bony fusion 5

This patient has documented cord compression at C3-C4 with posterior disc protrusion confirmed on both MRI and CT, meeting criteria for surgical intervention 1
The patient presents with symptoms of neural compression (neck pain with radiation to the arm) corresponding to the imaging findings, which is a key indication for ACDF 2, 6
The patient's activities of daily living are limited by these symptoms, further supporting the need for definitive surgical treatment 4, 7

Autologous bone provides superior fusion rates compared to some alternatives and is considered the "gold standard" for spinal fusion procedures 2
The use of the patient's own tissue eliminates concerns about disease transmission or immunologic rejection that might occur with allograft materials 5
Autograft has osteogenic, osteoinductive, and osteoconductive properties that promote solid fusion, which is particularly important at the critical C3-C4 level 1, 3

Titanium cages and other fusion devices, with or without bone graft substitutes, are also recommended options with Class II evidence 1, 2
PEEK cages may be considered with or without hydroxyapatite, though they have less supporting evidence (Class III) 4, 8