Surgical Outcome of a Zero-profile Device Comparing with Stand-alone Cage and Anterior Cervical Plate with Iliac Bone Graft in the Anterior Cervical Discectomy and Fusion

Object Although smoking has been shown to negatively affect fusion rates in patients undergoing multilevel fusions of the cervical and lumbar spine, the effect of smoking on fusion rates in patients undergoing single-level anterior cervical discectomy and fusion (ACDF) with allograft and plate fixation has yet to be thoroughly investigated. The objective of the present study was to address the effect of smoking on fusion rates in patients undergoing a 1-level ACDF with allograft and a locked anterior cervical plate. Methods This study is composed of patients from the control groups of 5 separate studies evaluating the use of an anterior cervical disc replacement to treat cervical radiculopathy. For each of the 5 studies the control group consisted of patients who underwent a 1-level ACDF with allograft and a locked cervical plate. The authors of the present study reviewed data obtained in a total of 573 patients; 156 patients were smokers and 417 were nonsmokers. A minimum follow-up period of 24 months was required for inclusion in this study. Fusion status was assessed by independent observers using lateral, neutral, and flexion/extension radiographs. Results An overall fusion rate of 91.4% was achieved in all 573 patients. A solid fusion was shown in 382 patients (91.6%) who were nonsmokers. Among patients who were smokers, 142 (91.0%) had radiographic evidence of a solid fusion. A 2-tailed Fisher exact test revealed a p value of 0.867, indicating no difference in the union rates between smokers and nonsmokers. Conclusions The authors found no statistically significant difference in fusion status between smokers and nonsmokers who underwent a single-level ACDF with allograft and a locked anterior cervical plate. Although the authors do not promote tobacco use, it appears that the use of allograft with a locked cervical plate in single-level ACDF among smokers produces similar fusion rates as it does in their nonsmoking counterparts.

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Anterior Cervical Discectomy and Fusion (ACDF): Comparison Between Zero Profile Implants and Anterior Cervical Plate and Spacer

Cureus ◽

10.7759/cureus.573 ◽

2016 ◽

Cited By ~ 3

Author(s):

Marjan Alimi ◽

Innocent Njoku ◽

Christoph P Hofstetter ◽

Apostolos J Tsiouris ◽

Kartik Kesavabhotla ◽

...

Keyword(s):

Anterior Cervical Discectomy ◽

Cervical Discectomy ◽

Cervical Plate ◽

Anterior Cervical Plate

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Feasibility of local bone dust as a graft material in anterior cervical discectomy and fusion

Journal of Neurosurgery Spine ◽

10.3171/2019.3.spine181416 ◽

2019 ◽

Vol 31 (4) ◽

pp. 480-485 ◽

Cited By ~ 1

Author(s):

Sehan Park ◽

Dong-Ho Lee ◽

Saemin Hwang ◽

Soohyun Oh ◽

Do-yon Hwang ◽

...

Keyword(s):

Bone Graft ◽

Fusion Rate ◽

Iliac Bone ◽

Anterior Cervical Discectomy ◽

Graft Material ◽

Filling Material ◽

Arm Pain ◽

Local Bone ◽

Iliac Bone Graft ◽

Vas Scores

OBJECTIVELocal bone dust has been used previously as a substitute cage filling material for iliac bone grafts during anterior cervical discectomy and fusion (ACDF). However, the impacts of local bone dust on fusion rate and clinical results remain unclear. Extragraft bone bridging (ExGBB) is a reliable CT finding indicating segmental fusion. This study was conducted to compare fusion rates for the use of local bone dust or an iliac auto bone graft during ACDF surgery and to evaluate the effect of implanting bone graft outside the cage.METHODSNinety-three patients who underwent ACDF at a single institution were included. An iliac bone graft was used as the polyetheretherketone (PEEK) cage filling graft material in 43 patients (iliac crest [IC] group). In the IC group, bone graft material was inserted only inside the cage. Local bone dust was used in 50 patients (local bone [LB] group). Bone graft material was inserted both inside and outside the cage in the LB group. Segmental fusion was assessed by 1) interspinous motion (ISM), 2) intragraft bone bridging (InGBB), and 3) ExGBB. Fusion rates, visual analog scale (VAS) scores for neck and arm pain, and Neck Disability Index (NDI) scores were compared between the 2 groups.RESULTSThe neck and arm pain VAS scores and NDI score improved significantly in both groups. Fusion rates assessed by ISM and InGBB did not differ significantly between the groups. However, the fusion rate in the LB group was significantly higher than that in the IC group when assessed by ExGBB (p = 0.02).CONCLUSIONSUsing local bone dust as cage filling material resulted in fusion rates similar to those for an iliac bone graft, while avoiding potential complications and pain caused by iliac bone harvesting. A higher rate of extragraft bone bridge formation was achieved by implanting local bone dust outside the cage.

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Functional outcome of anterior cervical discectomy and fusion with anterior cervical plate in cervical disc herniation

International Journal of Orthopaedics Sciences ◽

10.22271/ortho.2021.v7.i2g.2674 ◽

2021 ◽

Vol 7 (2) ◽

pp. 530-539

Author(s):

Dr. TH Prakashappa ◽

Dr. Mohan NS ◽

Dr. Siddesh Patil ◽

Dr. Arjun Kumar V

Keyword(s):

Functional Outcome ◽

Disc Herniation ◽

Anterior Cervical Discectomy ◽

Cervical Disc Herniation ◽

Cervical Disc ◽

Cervical Discectomy ◽

Cervical Plate ◽

Anterior Cervical Plate

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Comparative study of anterior cervical discectomy and fusion by anterior cervical plate and stand-alone cervical cage

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20203540 ◽

2020 ◽

Vol 6 (5) ◽

pp. 888

Author(s):

Ansari Muqtadeer Abdul Aziz ◽

Venktesh Dattatray Sonkawade ◽

Ansari Ishtyaque Abdul Aziz ◽

Nair Pradeepkumar Sasidharan

Keyword(s):

Cervical Spine ◽

Intraoperative Complications ◽

Anterior Cervical Discectomy ◽

Research Centre ◽

Cervical Disc ◽

Cervical Discectomy ◽

Single Level ◽

Incision Size ◽

Cervical Plate ◽

Anterior Cervical Plate

Background: Anterior cervical discectomy (ACD) was used for management of degenerative cervical disc disorders (DCDD) in previous days. Further research and developments in management of DCDD led to evolution of standard and widely used operative technique as anterior cervical discectomy and fusion (ACDF) by either anterior cervical plate (ACDF-ACP) with bone grafting or stand-alone cage (ACDF-SAC). There is less data available in literature regarding when and where to use ACDF-ACP and ACDF-SAC.Methods: The study was conducted on 20 patients operated in Government Medical College and Hospital and Pacific Hospital and Research Centre, Aurangabad from June 2018 to March 2020. These patients divided into group A - 10 patients, operated by ACDF-SAC which are further divided as group Aa - 6 patients - operated for single level ACDF-SAC and group Ab - 4 patients - operated for two level ACDF-SAC, group B - 10 patients, operated by ACDF-ACP which are further divided as group Ba - 5 patients - operated for single level ACDF-ACP and group Bb - 5 patients - operated for two level ACDF-ACP. Patients evaluated preoperatively and postoperatively using X-ray cervical spine anteroposterior (AP) and lateral views, MRI cervical spine, visual analogue scale (VAS) for pain, Robinson’s criteria and Cobb’s angle.Results: In our study we found, ACDF-SAC has small incision size, less intraoperative time, easy to carry out for surgeons, less intraoperative complications and better clinical outcome as compared to ACDF-ACP. Whereas only radiological results were better in ACDF-ACP than ACDF-SAC.Conclusions: ACDF-SAC is superior to ACDF-ACP for appropriately selected patients and in well experienced hands.

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