scholarly journals The impact of smoking on outcomes following anterior cervical fusion-nonfusion hybrid surgery: a retrospective single-center cohort study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Han Wang ◽  
Yang Meng ◽  
Hao Liu ◽  
Xiaofei Wang ◽  
Ying Hong
Keyword(s):  
Bone Loss ◽  
Clinical Outcomes ◽  
Smoking Status ◽  
Fusion Rate ◽  
Cervical Disc ◽  
Hybrid Surgery ◽  
Disc Disease ◽  
Cervical Disc Replacement ◽  
Early Fusion ◽  
The Impact

Abstract Background There is mixed evidence for the impact of cigarette smoking on outcomes following anterior cervical surgery. It has been reported to have a negative impact on healing after multilevel anterior cervical discectomy and fusion, however, segmental mobility has been suggested to be superior in smokers who underwent one- or two-level cervical disc replacement. Hybrid surgery, including anterior cervical discectomy and fusion and cervical disc replacement, has emerged as an alternative procedure for multilevel cervical degenerative disc disease. This study aimed to examine the impact of smoking on intermediate-term outcomes following hybrid surgery. Methods Radiographical and clinical outcomes of 153 patients who had undergone continuous two- or three-level hybrid surgery were followed-up to a minimum of 2-years post-operatively. The early fusion effect, 1-year fusion rate, the incidence of bone loss and heterotopic ossification, as well as the clinical outcomes were compared across three smoking status groups: (1) current smokers; (2) former smokers; (3) nonsmokers. Results Clinical outcomes were comparable among the three groups. However, the current smoking group had a poorer early fusion effect and 1-year fusion rate (P < 0.001 and P < 0.035 respectively). Both gender and smoking status were considered as key factors for 1-year fusion rate. Upon multivariable analysis, male gender (OR = 6.664, 95% CI: 1.248–35.581, P = 0.026) and current smoking status (OR = 0.009, 95% CI: 0.020–0.411, P = 0.002) were significantly associated with 1-year fusion rate. A subgroup analysis demonstrated statistically significant differences in both early fusion process (P < 0.001) and the 1-year fusion rate (P = 0.006) across the three smoking status groups in female patients. Finally, non-smoking status appeared to be protective against bone loss (OR = 0.427, 95% CI: 0.192–0.947, P = 0.036), with these patients likely to have at least one grade lower bone loss than current smokers. Conclusions Smoking is associated with poor outcomes following hybrid surgery for multilevel cervical disc disease. Current smokers had the poorest fusion rate and most bone loss, but no statistically significant differences were seen in clinical outcomes across the three groups.

scholarly journals Cervical sagittal alignment after Prestige LP cervical disc replacement: radiological results and clinical impacts from a single-center experience

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Xiaofei Wang ◽  
Yang Meng ◽  
Hao Liu ◽  
Hua Chen ◽  
Beiyu Wang ◽  
...  
Keyword(s):  
Sagittal Alignment ◽  
Disc Replacement ◽  
Cervical Disc ◽  
Adjacent Segment ◽  
Single Center ◽  
Disc Disease ◽  
Sagittal Vertical Axis ◽  
Cervical Disc Replacement ◽  
Cervical Sagittal Alignment ◽  
The Impact

Abstract Background Cervical disc replacement (CDR) has been widely used to treat one- and two-level cervical degenerative disc disease. Studies have shown the effectiveness of CDR in preserving range of motion (ROM) and delaying adjacent segment degeneration (ASD). Cervical sagittal alignment is an important factor affecting favorable clinical outcomes in cervical spine surgery. This study aimed to explore whether cervical sagittal alignment can be maintained after CDR and to identify the impact of cervical sagittal alignment on outcomes after CDR. Methods This was a single-center, retrospective study. 132 patients who underwent one-level CDR were included. Cervical sagittal alignments, including cervical lordosis (CL), segmental alignment (SA), sagittal vertical axis (SVA), T1 slope (T1s), and T1s minus CL (T1s-CL), were measured. The effects of cervical sagittal alignment on the CDR outcomes were analyzed. Patients were divided into the heterotopic ossification (HO) group and ASD group to determine the potential impacts of cervical sagittal parameters. Results The cervical sagittal alignment parameters, except for the SVA, were significantly improved after CDR and showed decreasing trends at the last follow-up. Significantly higher CL and T1s were found in patients with better ROM after CDR. SVA ≥ 20 mm increased the risk of anterior HO (odds ratio = 2.945, P = 0.007). Significantly kyphotic SA and lower T1s values were found in the ASD patients than in the non-ASD patients (P < 0.05). Patients with ASD at the inferior level showed significantly worse CL (P < 0.05). Conclusion CDR had limited function of improving cervical sagittal alignment. Poor cervical sagittal alignment after CDR was associated with HO, ASD, and less ROM.

Effect of intervertebral disc height on postoperative motion and clinical outcomes after Prodisc-C cervical disc replacement

2009 ◽  
Vol 9 (7) ◽  
pp. 551-555 ◽  
Author(s):  
Chan W.B. Peng ◽  
Martin Quirnoa ◽  
John A. Bendo ◽  
Jeffrey M. Spivak ◽  
Jeffrey A. Goldstein
Keyword(s):  
Intervertebral Disc ◽  
Clinical Outcomes ◽  
Disc Height ◽  
Disc Replacement ◽  
Cervical Disc ◽  
Cervical Disc Replacement ◽  
Intervertebral Disc Height

Is Anterior Bone Loss the Opposite of Anterior Heterotopic Ossification in Prestige-LP Cervical Disc Replacement?

2020 ◽  
Vol 136 ◽  
pp. e407-e418 ◽  
Author(s):  
Xiaofei Wang ◽  
Yang Meng ◽  
Hao Liu ◽  
Ying Hong ◽  
Beiyu Wang
Keyword(s):  
Bone Loss ◽  
Heterotopic Ossification ◽  
Disc Replacement ◽  
Cervical Disc ◽  
Cervical Disc Replacement

scholarly journals Association between anterior bone loss and anterior heterotopic ossification in hybrid surgery

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Junbo He ◽  
Hao Liu ◽  
Tingkui Wu ◽  
Chen Ding ◽  
Kangkang Huang ◽  
...  
Keyword(s):  
Bone Loss ◽  
Heterotopic Ossification ◽  
Adverse Outcomes ◽  
Hybrid Surgery ◽  
Disc Disease ◽  
Intervertebral Disc Space ◽  
Disc Space ◽  
Significant Difference ◽  
Space Angle

Abstract Background Hybrid surgery (HS) has become an alternative procedure for the treatment of multilevel cervical degenerative disc disease with satisfactory outcomes. However, some adverse outcomes have recently emerged, such as heterotopic ossification (HO) and anterior bone loss (ABL). Furthermore, HO was found mostly located in the posterior and lateral of the cervical intervertebral disc space. The mechanism of anterior heterotopic ossification (AHO) formation may be different, and its relationship with ABL was uncertain. Methods Radiographical and clinical outcomes of ninety-seven patients who had undergone contiguous two-level HS between December 2010 and December 2017 and with a minimum of 2-year follow-up were analyzed. Postoperative radiographs were evaluated and compared to the initial postoperative films to determine the incidence of ABL and AHO. Results The overall incidence rate of ABL was 44.3% (43/97). It was identified in 70.6% of AHO cases (33.3% mild, 41.7% moderate, 25.0% severe) and 38.8% of non-AHO cases (38.7% mild, 45.2% moderate, 16.1% severe). A significant association between ABL and AHO occurrence was found (P = 0.016). There was no significant difference in prosthesis–endplate depth ratio or disc space angle change between the AHO group and the non-AHO group (P > 0.05). Compared with data preoperatively, clinical outcome scores significantly improved after surgery in both the AHO and non-AHO groups, with no significant differences between the two groups (P > 0.05). Conclusion ABL was common in HS, and it related to AHO. The formation of AHO could be an integral part of postoperative bone remodeling, as well as ABL.

scholarly journals Result of the arc of movement of lower cervical spine after seven years of arthroplasty

2014 ◽  
Vol 13 (3) ◽  
pp. 185-187
Author(s):  
Luis Claudio de Velleca e Lima ◽  
Fernando Gritsch Sanchis
Keyword(s):  
Cervical Spine ◽  
Cervical Disc ◽  
Lower Cervical Spine ◽  
Lateral Bending ◽  
Disc Disease ◽  
Cervical Disc Replacement ◽  
The Right ◽  
Lost To Follow Up ◽  
Surgery Center

OBJECTIVE: To quantify the mobility of the lower cervical spine after seven years of total cervical disc replacement at two levels. METHOD: This clinical study was designed randomly and prospectively at the spine surgery center at the Hospital Nossa Senhora das Graças, in Canoas, RS-Brazil and at the Hospital Don João Becker, in Gravataí, RS-Brazil. Seventeen patients were included in the study that was designed to compare the data obtained from annual and sequential manner until the end of seven years. A comparison was made with the prior range of motion (ROM) of each patient. All patients were diagnosed with not tractable symptomatic cervical degenerative disc disease with two adjacent levels between C-3 and C-7. RESULTS: A total of patients underwent TDR in two levels and at the end of seven years, only one patient was lost to follow-up. The pre and postoperative ROM was the same in the first three years however after the fourth year there was a gradual decline with a loss of 12% of preoperative ROM in flexion, 21% in extension and 23% in the right and left lateral bending at the end of seven years. CONCLUSIONS: The clinical outcome of this study is evidence level IV in evaluating the ROM for Moby-C(r) for TDR in two adjacent levels at the lower cervical spine. These results show that the ROM is maintained during the first three years, gradually declining after that.

scholarly journals Incidence and outcomes of anterior bone loss in single-level Prestige LP cervical disc replacement

2020 ◽  
Vol 134 (1) ◽  
pp. 109-111
Author(s):  
Xiao-Fei Wang ◽  
Yang Meng ◽  
Hao Liu ◽  
Bei-Yu Wang ◽  
Ying Hong
Keyword(s):  
Bone Loss ◽  
Disc Replacement ◽  
Cervical Disc ◽  
Cervical Disc Replacement ◽  
Single Level
Sign in / Sign up

Export Citation Format

Share Document