scholarly journals Anterior cervical discectomy and fusion for cervical myelopathy using stand-alone tricortical iliac crest autograft: Predictive factors for neurological and fusion outcomes

2019 ◽  
Vol 27 (3) ◽  
pp. 230949901986916 ◽  
Author(s):  
Kenneth Kam Leung Yeung ◽  
Prudence Wing Hang Cheung ◽  
Jason Pui Yin Cheung
Keyword(s):  
Predictive Factors ◽  
Cervical Myelopathy ◽  
Odds Ratio ◽  
Multivariate Regression ◽  
Iliac Crest ◽  
Japanese Orthopaedic Association ◽  
Delayed Union ◽  
Anterior Cervical Discectomy ◽  
Cervical Discectomy ◽  
Non Union

Purpose: The purpose of this article is to investigate the outcomes after anterior cervical discectomy and fusion (ACDF) surgery with stand-alone tricortical iliac crest autograft and to determine predictive factors for poor neurological recovery, non-union, graft collapse and loss of C2–C7 sagittal alignment. Methods: This was a retrospective study involving patients with cervical myelopathy who underwent ACDF surgery with stand-alone tricortical iliac autograft between 2006 and 2016, with a minimum 2-year postoperative follow-up. Outcomes included the change in Japanese Orthopaedic Association (JOA) scores clinically and timing of fusion, graft height and C2–7 angle measured on lateral radiographs. Any complication such as neurological deterioration, non-union, graft collapse or loss of angle was recorded. Delayed union was considered as radiological union identified only beyond postoperative 6 months. Risk factors including age, smoking, drinking, comorbidities and operative levels were analysed through a multivariate regression for their respective influences on the various outcomes. Results: Of the 69 patients studied, none of the patients had non-union, while 33 (47.1%) achieved fusion in 6 months. The most common complications were anterior protrusion of graft (5.8%) and hoarseness (2.9%). The 1-year mean change in JOA score was 3.9 ± 2.7. The C2–7 angle gradually became more kyphotic, despite an initial lordosis correction intraoperatively. The graft height also gradually collapsed during subsequent follow-ups. Multivariate regression model suggested that diabetics (cumulative odds ratio 7.4) and drinkers (cumulative odds ratio 8.6) were associated with delayed union. Conclusion: ACDF using tricortical iliac crest autograft has satisfactory outcomes with low occurrence of complications. Diabetics and drinkers were predictors of delayed union.

scholarly journals Risk factor analysis of axial symptoms after single-segment anterior cervical discectomy and fusion: A retrospective study of 113 patients

2019 ◽  
Vol 47 (12) ◽  
pp. 6100-6108
Author(s):  
Lin-Feng Wang ◽  
Zhen Dong ◽  
De-Chao Miao ◽  
Yong Shen ◽  
Feng Wang
Keyword(s):  
Risk Factor ◽  
Retrospective Study ◽  
Japanese Orthopaedic Association ◽  
Anterior Cervical Discectomy ◽  
Occurrence Rate ◽  
Adjacent Segment ◽  
Disc Space ◽  
Cervical Discectomy ◽  
Single Segment ◽  
Axial Symptoms

Objective This retrospective study was performed to investigate the risk factors for axial symptoms (AS) after single-segment anterior cervical discectomy and fusion (ACDF). Methods One hundred thirteen patients with cervical spondylosis who had undergone single-segment ACDF from January 2012 to December 2015 were divided into those with and without AS (n = 34 and n = 79, respectively). Clinical data and radiological evaluation results were recorded. Results The occurrence rate of AS was 30.1% (34/113), and the average visual analog scale score was 4.5 points. Bony fusion was achieved in all cases during follow-up. There were no differences in age, sex, disease duration, diagnostic categories, operative segment, Japanese Orthopaedic Association score, or adjacent segment degeneration. However, cervical range of motion (CROM), cervical curvature, and disc space enlargement significantly differed between the groups. Logistic regression analysis revealed that CROM, cervical curvature, and disc space enlargement were independently associated with AS. Conclusions AS after single-segment ACDF is not rare. Disc space enlargement is a risk factor for AS, while higher CROM and lordotic cervical curvature are protective factors. Excessive or insufficient disc space enlargement could increase the incidence of AS. Maintaining CROM within the normal range and restoring cervical lordosis might help to prevent AS.

scholarly journals Adjacent-Level Ossification Development in Single-Level Standalone Anterior Cervical Discectomy and Fusion Versus Anterior Cervical Discectomy and Fusion With Plate

2020 ◽  
pp. 219256822090274
Author(s):  
Christopher Huang ◽  
Ralph Mobbs ◽  
Michael Selby ◽  
Kevin Phan ◽  
Prashanth Rao
Keyword(s):  
Confidence Interval ◽  
Odds Ratio ◽  
Case Control Study ◽  
Case Control ◽  
Anterior Cervical Discectomy ◽  
Adjacent Level ◽  
Retrospective Case ◽  
Cervical Discectomy ◽  
Surgical Data ◽  
Control Study

Study Design: Retrospective case control study. Objectives: Adjacent-level ossification development (ALOD) is a distinct form of adjacent segmental degeneration that has been recognized to occur after anterior cervical discectomy and fusion (ACDF). It is unclear whether ACDF with plate versus standalone has an effect on rates of ALOD. This retrospective case-control study aims to assess the rate of ALOD in a large series of patients undergoing ACDF with and without plate and factors causing ALOD. Methods: Data was collected for patients undergoing ACDF from January 2009 to July 2016. Data collected was from multiple centers and included demographic data, surgical data, radiological imaging at time of surgery, and serial follow-up imaging. The radiology for ALOD was independently reviewed. Cohorts were divided into ACDF with plate (Group P = plate) and ACDF without plate (Groups S = standalone) and outcomes were compared. Results: There were 260 patients with 138 (53%) in Group P and 122 (47%) in Group S. ALOD was observed in 15.3% of patients overall, 29% in group P and 2.8% in group S ( P < .001). Following multivariate adjustment, statistically significant association was found between use of plate and ALOD (odds ratio = 12.8, 95% confidence interval = 3.52-45.45, P < .001). Plate-to-disc distance <5 mm was significantly associated with ALOD (odds ratio = 13.5, 95% confidence interval = 3.83-47.62, P < .001). Conclusion: The use of anterior plate with ACDF was associated with ALOD. Plate-to-disc distance <5 mm was significantly associated with ALOD even after adjustment for confounding factors. We conclude utilization of standalone cages or cages with plate with more than 5 mm distance from adjacent disc to minimize ALOD.

Donor Site Morbidity After Anterior Iliac Crest Bone Harvest for Single-Level Anterior Cervical Discectomy and Fusion

Spine ◽  
2003 ◽  
Vol 28 (2) ◽  
pp. 134-139 ◽  
Author(s):  
Jeff S. Silber ◽  
D. Greg Anderson ◽  
Scott D. Daffner ◽  
Brian T. Brislin ◽  
J. Martin Leland ◽  
...  
Keyword(s):  
Iliac Crest ◽  
Donor Site ◽  
Donor Site Morbidity ◽  
Anterior Cervical Discectomy ◽  
Cervical Discectomy ◽  
Single Level

scholarly journals Multiple-Level Anterior Cervical Discectomy and Fusion Using PEEK Cages in Cervical Myelopathy. Is Anterior Platting Necessary?

2012 ◽  
Vol 2 (1) ◽  
pp. 1-9
Author(s):  
Ahmad Fouad ◽  
Wael Koptan ◽  
Yasser ElMiligui ◽  
Talaat ElHadidi ◽  
Mohammad El-Sharkawi
Keyword(s):  
Cervical Myelopathy ◽  
Anterior Cervical Discectomy ◽  
Multiple Level ◽  
Cervical Discectomy

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.

scholarly journals Is it Safe and Effective to Treat Complex Cervical Spondylotic Myelopathy Using Piezosurgery in Anterior Cervical Discectomy and Fusion?

2021 ◽  
Author(s):  
Yuwei Li ◽  
Shixin Zhao ◽  
Haijiao Wang ◽  
Peng Zhou ◽  
Wei Cui ◽  
...  
Keyword(s):  
Blood Loss ◽  
Surgical Complications ◽  
Cervical Spondylotic Myelopathy ◽  
Japanese Orthopaedic Association ◽  
Anterior Cervical Discectomy ◽  
Intraoperative Blood Loss ◽  
Traditional Group ◽  
Improvement Rate ◽  
Cervical Discectomy ◽  
Operative Duration

Abstract Objective To investigate the safety and efficacy of piezosurgery in anterior cervical discectomy and fusion (ACDF) for treating patients with cervical spondylotic myelopathy (CSM) coincident retrovertebral body osteophytes adjacent to the endplate or a free nucleus pulposus migrated to the vertebral body, posteriorly; known as complex cervical spondylotic myelopathy (cCSM) here.Methods Forty-seven patients with cCSM underwent ACDF surgery from 2014 to 2017. Among these patients, 26 underwent ACDF using piezosurgery (group A) and 21 underwent ACDF by traditional tools such as air drill, bone curet and gun-shaped bone forceps (group B). Average operative duration, intraoperative blood loss, surgical complications, preoperative and postoperative Japanese Orthopaedic Association (JOA) scores and improvement rate were measured.Results Average operative duration and intraoperative blood loss were significantly lower in the piezosurgery group than those in the traditional group (P < 0.01). The incidences of surgical complications were 3.8% and 23.8% in the piezosurgery and traditional groups (P < 0.05), respectively. Whereas JOA scores and improvement rate were insignificantly different at each data collection period (P > 0.05); preoperative, postoperative 3 days and postoperative 1 year follow-up were included.Conclusion For treating cCSM, both the piezosurgery and traditional tools led to significant neurological improvement. However, the piezosurgery was superior to the traditional tools in terms of operative duration, blood loss, and complication rate. Hence, the piezosurgery was a safe and effective adjunct for ACDF treating cCSM.

Sign in / Sign up

Export Citation Format

Share Document