Anterior Cervical Discectomy with Hydroxylapatite Fusion

Neurosurgery ◽  
1989 ◽  
Vol 25 (1) ◽  
pp. 39-43 ◽  
Author(s):  
Howard J. Senter ◽  
Rick Kortyna ◽  
William R. Kemp
Keyword(s):  
Interbody Fusion ◽  
Iliac Crest ◽  
Donor Site ◽  
Anterior Cervical Discectomy ◽  
Cervical Disc ◽  
Adjacent Level ◽  
Cervical Discectomy ◽  
Bone Plug ◽  
Cervical Disc Surgery

Abstract The outcome of microscopic anterior cervical discectomy with iliac crest interbody fusion in a group of 75 patients was compared with that of microscopic anterior cervical discectomy with synthetic hydroxylapatite fusion in a group of 84 patients. The rate of relief of myelopathy (70%) was similar in both groups, but those who underwent synthetic fusion had better long-term relief of radiculopathy, less need for a second operation at the same or an adjacent level, no resorption of the bone plug, comparable spinal alignment and stability, and the elimination of complications at the iliac crest donor site. The data suggest that hydroxylapatite fusion may be equal or superior to autologous iliac crest interbody fusion for anterior cervical disc surgery.

A prospective randomized comparison of rectangular titanium cage fusion and iliac crest autograft fusion in patients undergoing anterior cervical discectomy

2006 ◽  
Vol 4 (1) ◽  
pp. 1-9 ◽  
Author(s):  
Claudius Thomé ◽  
Olaf Leheta ◽  
Joachim K. Krauss ◽  
Dimitris Zevgaridis
Keyword(s):  
Clinical Outcome ◽  
Iliac Crest ◽  
Short Form ◽  
Donor Site ◽  
Anterior Cervical Discectomy ◽  
Cervical Disc ◽  
Cervical Discectomy ◽  
Titanium Cage ◽  
Sf 36 ◽  
Flexion Extension

Object The authors compare clinical outcome and fusion rates after iliac crest autograft (ICAG)– and rectangular titanium cage (RTC)–augmented fusion in patients undergoing anterior cervical discectomy (ACD). Methods One hundred consecutive patients with 127 levels of cervical disc disease refractory to conservative treatment were randomized into one of the two treatment groups (ICAG/RTC fusion). The visual analog scale was used by the patient to rate overall pain and head, neck, arm, and donor site pain separately. Myelopathy was documented according to Japanese Orthopaedic Association and Nurick grading systems. Outcome was analyzed using Odom criteria, the 36-Item Short Form (SF-36), and Patient Satisfaction Index scales. Fusion rates were assessed on standard and flexion–extension radiographs. Follow-up data of at least 12 months' duration were available for 95 patients. More residual overall pain after 12 months was documented in patients who underwent ICAG fusion (3.3 ± 2.5 [ICAG] and 2.2 ± 2.4 [RTC]; p < 0.05). Although arm and head pain were minimal in both groups, neck pain proved to be the predominant symptom (2.7 ± 2.5 [ICAG] and 1.9 ± 2.1 [RTC]), which resolved in only 67 and 48% of RTC-and ICAG-treated patients, respectively (p < 0.05). Myelopathy improved comparably in both groups. Regardless of increased pain in ICAG-treated patients, PSI and SF-36 scores were not significantly different between groups (only four [8%] of 47 ICAG-treated patients and five [10%] of 48 RTC-treated patients were unsatisfied). Good to excellent functional recovery according to Odom criteria was observed in 75 and 79% of ICAG- and RTC-treated patients, respectively. Fusion rates were 81 and 74%, respectively (p = 0.51). Conclusions Fusion rates and clinical outcome at 12 months after ACD were comparable between patients who underwent ICAG and RTC fusion. The use of rectangular cages, however, avoids donor site morbidity and reduces overall pain and, thus, seems to be an advantageous treatment alternative.

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

Anterior cervical discectomy and interbody fusion by endoscopic approach: a preliminary report

2008 ◽  
Vol 8 (1) ◽  
pp. 17-21 ◽  
Author(s):  
Jiangwei Tan ◽  
Yanping Zheng ◽  
Liangtai Gong ◽  
Xinyu Liu ◽  
Jianmin Li ◽  
...  
Keyword(s):  
Disc Herniation ◽  
Endoscopic Surgery ◽  
Interbody Fusion ◽  
Intraoperative Complications ◽  
Postoperative Hemorrhage ◽  
Endoscopic Approach ◽  
Anterior Cervical Discectomy ◽  
Cervical Disc Herniation ◽  
Cervical Disc ◽  
Cervical Discectomy

Object The authors report the short-term results of anterior cervical discectomy and interbody fusion performed via an endoscopic approach. Methods Thirty-six patients who underwent anterior cervical discectomy and fusion (ACDF) performed using endoscopic surgery were selected for this study. The indications for surgery were cervical disc herniation caused by neck injury, spondylotic myelopathy, cervical radiculopathy, and solitary ossification of the posterior longitudinal ligament (OPLL). The involved levels included C3–4, C4–5, C5–6, and C6–7. The working channel was inserted through a 20-mm transverse incision, the protruding discs or area of OPLL were excised for complete decompression, and then an appropriate intervertebral polyetheretherketone fusion cage was implanted. Results The time spent in surgery was 120 minutes on average (range 50–150 minutes), and the mean blood loss was 55 ml (range 20–140 ml). There were no intraoperative complications and no symptoms of irritation in the laryngopharynx after surgery. However, postoperative hemorrhage of the incision occurred in 1 case. The follow-up period ranged from 26–50 months (mean 38.5 months). Postoperative Japanese Orthopaedic Association and visual analog scale scores improved significantly. Conclusions Endoscopic surgery for ACDF can produce satisfactory results in patients with cervical disc herniation, cervical myelopathy, or radiculopathy. The optimal levels for this procedure are C4–5 and C5–6. Compared with a traditional approach, this technique has great advantages in terms of cosmetic results, intraoperative visualization, and postoperative recovery course. Nevertheless, every precaution should be taken to avoid possible complications, such as postoperative hemorrhage.

scholarly journals Long-Term Results of Multiple Anterior Cervical Discectomy with Cage Fusion Technique: Results of Multiple Centre Study

2019 ◽  
Vol 7 (17) ◽  
pp. 2824-2828 ◽  
Author(s):  
Hamdi Mostafa ◽  
Mohsen Lotfi ◽  
M. Wahid
Keyword(s):  
Neck Pain ◽  
Anterior Cervical Discectomy ◽  
Long Term Results ◽  
Cervical Disc ◽  
Fusion Technique ◽  
Cervical Discectomy ◽  
Cage Subsidence ◽  
Long Term Follow Up

BACKGROUND: Cervical herniation is commonly treated by anterior cervical discectomy and fusion (ACDF) if conservative management has failed in relief of the patient's symptoms. Disc fusion is needed after ACDF as anterior longitudinal ligament will be absent after doing the operation, especially if multiple levels are needed. The occurrence of complications as cage subsidence and adjacent segment failure related to the length of follow up as they are increasing in percentage is directly proportional to the length of follow up. AIM: Analysis of the results for patients who underwent 3 levels of ACDF with cage fusion for short term and long term follow up in multiple centres as the visual analogue score for neck pain & brachialgia. METHODS: This retrospective cohort series of 68 patients selected out of 136 patients suffering from 3 levels of degenerative cervical disc disease who were unresponsive to adequate conservative therapy. All cases were treated at one of the neurosurgery departments of 3 different hospitals (Naser institute for research and treatment hospital, Haram hospital for research and treatment and Misr university for science and technology) by the same surgical team in the period from February 2012 to February 2017. RESULTS: We found in this study;68 patients fulfilling the inclusion criteria, of the 29 patients underwent 3 levels of ACDF starting from C3-4 (42.65%) and 39 patients who underwent 3 levels of ACDF starting from C4-5 (57.35%). Clinical assessment for VAS pain score for both neck pain and radiculopathy were done before the surgery and immediately post-operative and during each time follow up visit and we found statistically significant immediate postoperative improvement. (P ˂ 0.05) CONCLUSION: Stand-alone three levels of an anterior cervical discectomy with cage fusion technique improved the clinical outcomes on long term follow up.

scholarly journals Mid- to long-term rates of symptomatic adjacent-level disease requiring surgery after cervical total disc replacement compared with anterior cervical discectomy and fusion: a meta-analysis of prospective randomized clinical trials

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Yifei Deng ◽  
Guangzhou Li ◽  
Hao Liu ◽  
Ying Hong ◽  
Yang Meng
Keyword(s):  
Anterior Cervical Fusion ◽  
Anterior Cervical Discectomy ◽  
Disc Replacement ◽  
Cervical Disc ◽  
Cervical Fusion ◽  
Adjacent Level ◽  
Cervical Total Disc Replacement ◽  
Cervical Disc Replacement

Abstract Background Thus far, no meta-analysis focusing on the mid- to long-term incidence of adjacent segment disease requiring surgery after cervical total disc replacement and anterior cervical discectomy and fusion has been published yet. This study aimed to compare mid- to long-term rates of symptomatic adjacent-level disease requiring surgery after cervical disc replacement and anterior cervical fusion. Methods A meta-analysis was performed, and only randomized controlled trials with a follow-up period of more than 48 months reporting rates of symptomatic adjacent-level disease requiring surgery after cervical total disc replacement and anterior cervical discectomy and fusion were included. Results The analysis revealed that the overall rate of symptomatic adjacent-level disease requiring surgery in the cervical disc replacement group was significantly lower than that of the anterior cervical fusion group at 48–120 months’ follow-up. The subgroup analysis of different follow-up periods also yielded the same results. The rate of symptomatic adjacent-level disease requiring surgery in the cervical disc replacement group using unrestricted prosthesis was significantly lower than that of the anterior cervical fusion group (p < 0.001); however, the cervical disc replacement group using semi-restricted prosthesis showed no statistical difference compared with the fusion group. Conclusions Our review suggests that cervical disc replacement is preferable to anterior cervical fusion in reducing the incidence of symptomatic adjacent-level disease requiring surgery at mid- to long-term follow-up. A review of the literature also demonstrated that randomized controlled trials investigating the rate of symptomatic adjacent-level disease requiring surgery were insufficient; therefore, studies focusing on this subject with longer-term follow-up are warranted.

scholarly journals Prospective controlled study of rectangular titanium cage fusion compared with iliac crest autograft fusion in anterior cervical discectomy

2002 ◽  
Vol 12 (1) ◽  
pp. 1-8 ◽  
Author(s):  
Dimitris Zevgaridis ◽  
Claudius Thomé ◽  
Joachim K. Krauss
Keyword(s):  
Iliac Crest ◽  
Anterior Cervical Discectomy ◽  
Alternative Methods ◽  
Cervical Disc ◽  
Controlled Study ◽  
Autogenous Bone ◽  
Cervical Discectomy ◽  
Titanium Cage ◽  
Prospective Controlled Study ◽  
Titanium Cages

Object The complications of autogenous bone grafting compel spine surgeons to seek alternative methods for cervical spinal fusion. This prospective study was conducted to evaluate the safety and efficacy of using rectangular titanium cage fusion compared with the widely performed iliac crest autograft fusion. Methods A total of 36 patients with cervical disc disease in whom an anterior approach was indicated for discectomy were included in this prospective controlled study. The first 18 consecutive patients received iliac crest autograft; the next 18 consecutive patients received rectangular titanium cages. The intergroup demographic and clinical data were comparable. All patients attended follow up for 1 year. According to Odom criteria, 15 (83%) of 18 patients in both groups experienced good to excellent functional recovery. According to the Patient Satisfaction Index, 17 (94%) of 18 patients in both groups were satisfied. The evaluation of neck pain and arm pain did not indicate statistically significant differences between either group. Fusion was present after 1 year in 16 (89%) of 18 patients who received iliac crest autografts and in 15 (83%) of 18 patients who received rectangular titanium cages. In the autograft group, a pseudarthrosis was present in one patient and marked hip pain was observed in three patients. In the cage group, there was one case of temporary vocal cord paresis but no implant-related complications. Conclusions The authors conclude that the use of titanium cages in anterior cervical discectomy constitutes a safe and efficient alternative to iliac crest bone autograft.

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