P87. Range of motion of cervical spine arthroplasty with Spinal Kinetics (elastomer), Prodisc-C (metal to UHMWPE), Prestige (metal only) artificial discs and anterior cervical discectomy and fusion

2005 ◽  
Vol 5 (4) ◽  
pp. S151-S152
Author(s):  
Daniel Kim ◽  
Jesse Lim ◽  
Max Lee ◽  
Jon Park
Keyword(s):  
Cervical Spine ◽  
Range Of Motion ◽  
Anterior Cervical Discectomy ◽  
Cervical Discectomy

Range of motion change after cervical arthroplasty with ProDisc-C and Prestige artificial discs compared with anterior cervical discectomy and fusion

2007 ◽  
Vol 7 (1) ◽  
pp. 40-46 ◽  
Author(s):  
Ung-Kyu Chang ◽  
Daniel H. Kim ◽  
Max C. Lee ◽  
Rafer Willenberg ◽  
Se-Hoon Kim ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Axial Rotation ◽  
Anterior Cervical Discectomy ◽  
Artificial Disc ◽  
Lateral Bending ◽  
Cervical Arthroplasty ◽  
Cervical Discectomy ◽  
Motion Modes ◽  
Adjacent Segments ◽  
The Prestige

Object Range of motion (ROM) changes were evaluated at the surgically treated and adjacent segments in cadaveric specimens treated with two different cervical artificial discs compared with those measured in intact spine and fusion models. Methods Eighteen cadaveric human cervical spines were tested in the intact state for the different modes of motion (extension, flexion, lateral bending, and axial rotation) up to 2 Nm. Three groups of specimens (fitted with either the ProDisc-C or Prestige II cervical artificial disc or submitted to anterior cervical discectomy and fusion [ACDF]) were tested after implantation at C6–7 level. The ROM values were measured at treated and adjacent segments, and these values were then compared with those measured in the intact spine. Results At the surgically treated segment, the ROM increased after arthroplasty compared with the intact spine in extension (54% in the ProDisc-C group, 47% in the Prestige group) and in flexion (27% in the ProDisc-C group, 10% in the Prestige group). In bending and rotation, the postarthroplasty ROMs were greater than those of the intact spine (10% in the ProDisc-C group and 55% in the Prestige group in bending, 17% in the ProDisc-C group and 50% in the Prestige group in rotation). At the adjacent levels the ROMs decreased in all specimens treated with either artificial disc in all modes of motion (< 10%) except for extension at the inferior the level (29% decrease for ProDisc-C implant, 12% decrease for Prestige disc). The ROM for all motion modes in the ACDF-treated spine decreased at the treated level (range 18–44%) but increased at the adjacent levels (range 3–20%). Conclusions Both ProDisc-C and Prestige artificial discs were associated with increased ROM at the surgically treated segment compared with the intact spine with or without significance for all modes of testing. In addition, adjacent-level ROM decreased in all modes of motion except extension in specimens fitted with both artificial discs.

scholarly journals Biomechanical Analysis of an Anterior Cervical Discectomy and Fusion Pseudarthrosis Model Revised With Machined Interfacet Allograft Spacers

2019 ◽  
Vol 10 (8) ◽  
pp. 973-981
Author(s):  
Raymond J. Hah ◽  
Ram Alluri ◽  
Paul A. Anderson
Keyword(s):  
Range Of Motion ◽  
Study Design ◽  
Axial Rotation ◽  
Biomechanical Analysis ◽  
Anterior Cervical Discectomy ◽  
Lateral Bending ◽  
Cervical Discectomy ◽  
Single Level ◽  
Flexion Extension ◽  
Potential Applications

Study Design: Biomechanics study. Objectives: To evaluate the biomechanical advantage of interfacet allograft spacers in an unstable single-level and 2-level anterior cervical discectomy and fusion (ACDF) pseudoarthrosis model. Methods: Nine single-level and 8 two-level ACDF constructs were tested. Range of motion in flexion-extension (FE), lateral bending (LB), and axial rotation (AR) at 1.5 N m were collected in 4 testing configurations: (1) intact spine, (2) ACDF with interbody graft and plate/screw, (3) ACDF with interbody graft and plate/loosened screws (loose condition), and (4) ACDF with interbody graft and plate/loosened screws supplemented with interfacet allograft spacers (rescue condition). Results: All fixation configurations resulted in statistically significant decreases in range of motion in all bending planes compared with the intact spine ( P < .05). One Level. Performing ACDF with interbody graft and plate on the intact spine reduced FE, LB, and AR 60.0%, 64.9%, and 72.9%, respectively. Loosening the ACDF screws decreased these reductions to 40.9%, 44.6%, and 52.1%. The addition of interfacet allograft spacers to the loose condition increased these reductions to 74.0%, 84.1%, and 82.1%. Two Level. Performing ACDF with interbody graft and plate on the intact spine reduced FE, LB, and AR 72.0%, 71.1%, and 71.2%, respectively. Loosening the ACDF screws decreased these reductions to 55.4%, 55.3%, and 51.3%. The addition of interfacet allograft spacers to the loose condition significantly increased these reductions to 82.6%, 91.2%, and 89.3% ( P < .05). Conclusions: Supplementation of a loose ACDF construct (pseudarthrosis model) with interfacet allograft spacers significantly increases stability and has potential applications in treating cervical pseudarthrosis.

scholarly journals Late deep cervical infection after anterior cervical discectomy and fusion: a case report and literature review

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Ying-Chun Chen ◽  
Lin Zhang ◽  
Er-Nan Li ◽  
Li-Xiang Ding ◽  
Gen-Ai Zhang ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Esophageal Perforation ◽  
Radical Neck Dissection ◽  
Titanium Implant ◽  
Anterior Cervical Discectomy ◽  
Antibiotic Administration ◽  
Cervical Discectomy ◽  
Cervical Infection ◽  
Unstable Cervical Spine ◽  
Degenerative Cervical Spine

Abstract Background Anterior cervical discectomy and fusion (ACDF) is often performed for the treatment of degenerative cervical spine. While this procedure is highly successful, 0.1–1.6% of early and late postoperative infection have been reported although the rate of late infection is very low. Case presentation Here, we report a case of 59-year-old male patient who developed deep cervical abscess 30 days after anterior cervical discectomy and titanium cage bone graft fusion (autologous bone) at C3/4 and C4/5. The patient did not have esophageal perforation. The abscess was managed through radical neck dissection approach with repated washing and removal of the titanium implant. Staphylococcus aureus was positively cultured from the abscess drainage, for which appropriate antibiotics including cefoxitin, vancomycin, levofloxacin, and cefoperazone were administered postoperatively. In addition, an external Hallo frame was used to support unstable cervical spine. The patient’s deep cervical infection was healed 3 months after debridement and antibiotic administration. His cervial spine was stablized 11 months after the surgery with support of external Hallo Frame. Conclusions This case suggested that deep cervical infection should be considered if a patient had history of ACDF even in the absence of esophageal perforation.

3-Tesla Kinematic MRI of the Cervical Spine for Evaluation of Adjacent Level Disease After Monosegmental Anterior Cervical Discectomy and Arthroplasty

Spine ◽  
2017 ◽  
Vol 42 (4) ◽  
pp. 224-231
Author(s):  
Steffen K. Fleck ◽  
Soenke Langner ◽  
Christian Rosenstengel ◽  
Rebecca Kessler ◽  
Marc Matthes ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Anterior Cervical Discectomy ◽  
3 Tesla ◽  
Adjacent Level ◽  
Cervical Discectomy

Unilateral cervical facet dislocation: a biomechanical study of several constructs including unilateral lateral mass fixation supplemented by an interspinous cable

2012 ◽  
Vol 16 (3) ◽  
pp. 251-256 ◽  
Author(s):  
Ron I. Riesenburger ◽  
Tejaswy Potluri ◽  
Nikhil Kulkarni ◽  
William Lavelle ◽  
Marie Roguski ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Gold Standard ◽  
Biomechanical Study ◽  
Anterior Cervical Discectomy ◽  
Lateral Mass ◽  
Intact Specimen ◽  
Cervical Discectomy ◽  
Lateral Mass Screws ◽  
The Right ◽  
Cervical Facet

Object Both ventral and dorsal operative approaches have been used to treat unilateral cervical facet injuries. The gold standard ventral approach is anterior cervical discectomy and fusion. There is, however, no clear gold standard dorsal operation. In this study, the authors tested the stability of multiple posterior constructs, including unilateral lateral mass fixation supplemented by an interspinous cable. Methods Six fresh human cervical spine specimens (C3–T1) were tested by applying pure moments to the C-3 vertebral body in increments of 0.5 Nm from 0 Nm to 2.0 Nm. Each specimen was tested in the following 8 conditions (in the order shown): 1) intact; 2) after destabilization via injury to the C5–6 facet; 3) with bilateral C5–6 lateral mass screws and rods; 4) after further destabilization by creating a right unilateral lateral mass fracture of C-5 (which rendered secure screw placement into the right C-5 lateral mass impossible); 5) with unilateral left C5–6 lateral mass screws and rod; 6) with unilateral C5–6 lateral mass screws and rod supplemented with an interspinous cable; 7) with a bilateral multilevel dorsal construct C4–6; and 8) after a C5–6 anterior cervical discectomy and fusion (ACDF) procedure with a polyetheretherketone graft and plate. Results The bilateral C5–6 lateral mass construct reduced the range of C5–6 motion to 33.6% of normal. The unilateral C5–6 lateral mass construct resulted in an increased range of motion to 110.1% of normal. The unilateral lateral mass construct supplemented by an interspinous cable reduced the C5–6 range of motion to 89.4% of normal. The bilateral C4–6 lateral mass construct reduced the C5–6 range of motion to 44.2% of normal. The C5–6 ACDF construct reduced the C5–6 range of motion to 62.6% of normal. Conclusions The unilateral lateral mass construct supplemented by an interspinous cable does reduce range of motion compared with an intact specimen, but is significantly inferior to a C4–6 bilateral lateral mass construct. When using a dorsal approach, the unilateral construct with a cable should only be considered in selected instances.

scholarly journals Pseudarthrosis rate following anterior cervical discectomy with fusion using an allograft cellular bone matrix: a multi-institutional analysis

2021 ◽  
Vol 50 (6) ◽  
pp. E6
Author(s):  
Stephen M. Bergin ◽  
Timothy Y. Wang ◽  
Christine Park ◽  
Shashank Rajkumar ◽  
C. Rory Goodwin ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Bone Growth ◽  
Bone Matrix ◽  
Anterior Cervical Discectomy ◽  
Cervical Discectomy ◽  
Cervical Spine Surgery ◽  
Single Level ◽  
Flexion Extension ◽  
Index Level ◽  
Instrumentation Failure

OBJECTIVE The use of osteobiologics, engineered materials designed to promote bone healing by enhancing bone growth, is becoming increasingly common for spinal fusion procedures, but the efficacy of some of these products is unclear. The authors performed a retrospective, multi-institutional study to investigate the clinical and radiographic characteristics of patients undergoing single-level anterior cervical discectomy with fusion performed using the osteobiologic agent Osteocel, an allograft mesenchymal stem cell matrix. METHODS The medical records across 3 medical centers and 12 spine surgeons were retrospectively queried for patients undergoing single-level anterior cervical discectomy and fusion (ACDF) with the use of Osteocel. Pseudarthrosis was determined based on CT or radiographic imaging of the cervical spine. Patients were determined to have radiographic pseudarthrosis if they met any of the following criteria: 1) lack of bridging bone on CT obtained > 300 days postoperatively, 2) evidence of instrumentation failure, or 3) motion across the index level as seen on flexion-extension cervical spine radiographs. Univariate and multivariate analyses were then performed to identify independent preoperative or perioperative predictors of pseudarthrosis in this population. RESULTS A total of 326 patients met the inclusion criteria; 43 (13.2%) patients met criteria for pseudarthrosis, of whom 15 (34.9%) underwent revision surgery. There were no significant differences between patients with and those without pseudarthrosis, respectively, for patient age (54.1 vs 53.8 years), sex (34.9% vs 47.4% male), race, prior cervical spine surgery (37.2% vs 33.6%), tobacco abuse (16.3% vs 14.5%), chronic kidney disease (2.3% vs 2.8%), and diabetes (18.6% vs 14.5%) (p > 0.05). Presence of osteopenia or osteoporosis (16.3% vs 3.5%) was associated with pseudarthrosis (p < 0.001). Implant type was also significantly associated with pseudarthrosis, with a 16.4% rate of pseudarthrosis for patients with polyetherethereketone (PEEK) implants versus 8.4% for patients with allograft implants (p = 0.04). Average lengths of follow-up were 27.6 and 23.8 months for patients with and those without pseudarthrosis, respectively. Multivariate analysis demonstrated osteopenia or osteoporosis (OR 4.97, 95% CI 1.51–16.4, p < 0.01) and usage of PEEK implant (OR 2.24, 95% CI 1.04–4.83, p = 0.04) as independent predictors of pseudarthrosis. CONCLUSIONS In patients who underwent single-level ACDF, rates of pseudarthrosis associated with the use of the osteobiologic agent Osteocel are higher than the literature-reported rates associated with the use of alternative osteobiologics. This is especially true when Osteocel is combined with a PEEK implant.

scholarly journals Outcome Study of Anterior Cervical Discectomy and Fusion with Lordotic Cage Insertion

2021 ◽  
Author(s):  
Nattawut Niljianskul
Keyword(s):  
Cervical Spine ◽  
Cobb Angle ◽  
Japanese Orthopaedic Association ◽  
Intervertebral Disk ◽  
Anterior Cervical Discectomy ◽  
P Value ◽  
Sagittal Vertical Axis ◽  
Cervical Discectomy ◽  
Radiographic Outcomes ◽  
Disk Height

Objective: This study retrospectively evaluated the clinical and radiographic outcomes following the use of a lordotic cage in anterior cervical discectomy and fusion (ACDF).Material and Methods: All patients who underwent ACDF, at Vajira Hospital; between May 2017 and May 2020, were included in this study. Radiographic images were used to evaluate the device-level Cobb angle (DLCA), segmental Cobb angle (SCA), global Cobb angle (GCA), sagittal vertical axis (SVA), sagittal alignment (SA), and intervertebral disk height. The visual analog scale (VAS) for neck pain, and the Japanese Orthopaedic Association (JOA) score were reviewed as part of the patient’s medical records. Preoperative DLCA, SCA, GCA, SVA, SA, and intervertebral disk height measurements were compared with postoperative measurements at 1 year.Results: A total of 51 patients (88 disks), having undergone ACDF with lordotic cage insertion were included in this study. The initial curvature of the cervical spine was diagnosed as kyphosis in 30 (58.8%) patients, and as lordosis in 21 (41.2%) patients. There was significant improvement in the VAS, JOA, DLCA, SCA, GCA, SVA, SA, and intervertebral disk height after ACDF (p-value<0.050). In patients with preoperative kyphosis, the greatest changes were observed in the GCA (p-value=0.004).Conclusion: The use of a lordotic cage in ACDF improved both the clinical and radiographic outcomes of all postoperative parameters, regardless of the patient’s preoperative cervical spine curvature; although, patients with preoperative kyphosis had greater improvement in GCA.

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