Use of the Solis cage and local autologous bone graft for anterior cervical discectomy and fusion: early technical experience

2005 ◽  
Vol 2 (2) ◽  
pp. 116-122 ◽  
Author(s):  
Amjad Shad ◽  
John C. D. Leach ◽  
Peter J. Teddy ◽  
Tom A. D. Cadoux-Hudson
Keyword(s):  
Neck Pain ◽  
Donor Site ◽  
Japanese Orthopaedic Association ◽  
Autologous Bone Graft ◽  
Anterior Cervical Discectomy ◽  
Anterior Plate ◽  
Content Type ◽  
Cervical Discectomy ◽  
Arm Pain ◽  
Fine Print

Object. The authors prospectively evaluated the clinical and radiological outcomes after anterior cervical discectomy and fusion (ACDF) involving placement of a Solis cage and local autograft in patients who presented with symptomatic cervical spondylosis. Methods. Twenty-two consecutive patients underwent ACDF for radiculopathy (13 cases), myeloradiculopathy (eight cases), or myelopathy alone (one case) and were assessed at 3, 6, and 12 months. Plain cervical spine radiography demonstrated a significant change in both local (p < 0.05) and regional (p < 0.05) kyphotic angles as well as an increase in segmental height (p < 0.05). At 12 months, plain radiography demonstrated Grades I, II, and III new bone formation in two, three, and 17 patients, respectively. Clinical outcomes were assessed using a visual analog scale for both neck and arm pain and a modified Japanese Orthopaedic Association (JOA) scale for myelopathy. There was a significant improvement in both arm (p < 0.05) and neck pain (p < 0.05). At 12 months, 16 (84%) of 19 and 19 (86%) of 22 patients reported complete resolution of arm pain and neck pain, respectively. There was a significant improvement in JOA scores following surgery (p < 0.05). There were two complications in the series: one case of deep venous thrombosis and one case of postoperative arm pain that resolved after conservative treatment. There were no technical complications. Conclusions. Early experience with Solis cage—augmented ACDF indicates good clinical and radiological outcomes; additionally, there are the advantages of absent donor site morbidity and anterior plate system—related morbidity.

Anterior cervical arthrodesis using DOC dynamic stabilization implant for improvement in sagittal angulation and controlled settling

2003 ◽  
Vol 98 (1) ◽  
pp. 8-13 ◽  
Author(s):  
Bikash Bose
Keyword(s):  
Anterior Cervical Discectomy ◽  
Related Complication ◽  
Common Procedure ◽  
Content Type ◽  
Cervical Discectomy ◽  
Arm Pain ◽  
Advantages And Disadvantages ◽  
Cervical Spondylotic Radiculopathy ◽  
Donor Graft ◽  
Fine Print

Object. Placing instrumentation in the anterior cervical spine is a common procedure. The bi- and unicortical systems currently available, however, have distinct advantages and disadvantages. The author reports a prospective series in which a new dynamized anterior cervical fixation system was evaluated. Methods. Thirty-seven patients underwent anterior cervical discectomy and fusion in which the DOC ventral cervical stabilization system was used for indications including cervical spondylotic radiculopathy, disc herniation, trauma, and myelopathy. Patients underwent anterior cervical discectomy and interbody fusion and/or corpectomy. Preoperative and postoperative clinical data included assessment of spinal cord and nerve root deficit, function, neck pain, and arm pain. Preoperative and postoperative radiographic data included sagittal angle, translation, and settling of the graft. Fusion status was determined by the presence of trabecular bridging bone on plain anteroposterior and lateral cervical radiographs. At a mean follow-up time of 1.3 years, postoperative neck or arm pain was resolved in 52% of the patients, restriction on function was mild or absent in 88%, and fusion was successful in 80% of patients and 88% of the treated levels. There was one implant-related complication, one significant dysphagia complication, and a 10.8% donor graft site complication rate. Conclusions. The use of this system led to a high percentage of pain relief and radiographic fusion. The sagittal angle was controlled while allowing for graft settling. There were no implant failures.

scholarly journals Anterior cervical discectomy and fusion with polyetheretherketone cages in the management of single and double level cervical spondylotic myelopathy-our experiences of 80 cases

KYAMC Journal ◽  
2018 ◽  
Vol 9 (1) ◽  
pp. 32-34
Author(s):  
Md Anowarul Islam ◽  
Mohd Alamgir Hossain ◽  
Ahmed Asif Iqbal ◽  
Md Qumruzzaman Parvez ◽  
Md Ahsanuzzaman ◽  
...  
Keyword(s):  
Clinical Outcome ◽  
Donor Site ◽  
Fusion Rate ◽  
Anterior Cervical Discectomy ◽  
Cervical Discectomy ◽  
X Ray ◽  
Arm Pain ◽  
Operative Complications ◽  
Medical University

Background: Anterior cervical discectomy with fusion (ACDF) is challenging with respect to both patient selection and choice of surgical procedure.Objectives: The aim of this study was to evaluate the clinical outcome of anterior cervical discectomy and fusion with an artificial cage made of polyetheretherketoneMaterials & Methods: From January 2012 to January 2017, 80 consecutive patients referred to the Department of spine surgery, Bangabandhu Shekh Mujib Medical University were recruited for the study. Postoperative Clinical outcome assessed with Nurick scale for myelopathy, Odom's criteria for functional outcome and Visual Analogue Scale (VAS) for both neck and arm pain. Radiological fusion was assessed by X-ray. Operative complications were reported.Results: 36 patients were operated for one level discectomy and fusion with PEEK cages and 44 patients for two levels. There were 48 (60%) males and 32 (40%) females. The age of the patients ranged from 30-72 years, a mean ± SD 45 ± 8.34. At the 2 years clinical follow-up, there were significant post operative improvements of Nurick scale, and VAS comparative to preoperative record. According to Odom's criteria, 72/80 patients (90%) were graded excellent-good.Conclusion: Anterior cervical discectomy and fusion with polyetheretherketone (PEEK) cage is an effective treatment of cervical myelopathy having higher fusion rate and lack of donor site morbidity.KYAMC Journal Vol. 9, No.-1, April 2018, Page 32-34

Vulnerability of the subcostal nerve to injury during bone graft harvesting from the iliac crest

2004 ◽  
Vol 1 (1) ◽  
pp. 87-89 ◽  
Author(s):  
Dean Chou ◽  
Phillip B. Storm ◽  
James N. Campbell
Keyword(s):  
Bone Graft ◽  
Iliac Crest ◽  
Donor Site ◽  
Autologous Bone Graft ◽  
Content Type ◽  
Bone Harvesting ◽  
Cutaneous Branch ◽  
Bone Graft Harvesting ◽  
Autologous Bone ◽  
Fine Print

Object. Autologous bone graft harvesting from the iliac crest remains the gold standard for fusion surgery. One disadvantage of autologous bone harvesting is the patient's enduring postoperative pain at the donor site. Nerve injury is one of the postulated mechanisms that may account for this pain. The object of this study was to determine whether the lateral cutaneous branch of the subcostal nerve is vulnerable to injury in the process of obtaining grafts from the anterior iliac crest. Methods. Anatomical dissections were performed on 10 cadaveric specimens to ascertain the size of the T-12 subcostal nerve and its position in relation to the iliac crest. Conclusions. The lateral cutaneous branch of the subcostal nerve may lie as close as 6 cm from the anterior superior iliac spine. This nerve is very vulnerable to injury when harvesting bone from the anterior iliac crest. Knowledge of the anatomy may decrease the risk of injury to this nerve.

Bilateral vocal cord paralysis following anterior cervical discectomy and fusion

1998 ◽  
Vol 89 (5) ◽  
pp. 839-843 ◽  
Author(s):  
Thomas J. Manski ◽  
Michael D. Wood ◽  
Stewart B. Dunsker
Keyword(s):  
Vocal Cord ◽  
Surgical Procedure ◽  
Vocal Cord Paralysis ◽  
Anterior Cervical Discectomy ◽  
Neurosurgical Procedures ◽  
Bilateral Vocal Cord Paralysis ◽  
Content Type ◽  
Cervical Discectomy ◽  
Unilateral Vocal Cord Paralysis ◽  
Fine Print

✓ The authors report a rare case of bilateral vocal cord paralysis following anterior cervical discectomy and fusion (ACD/F) in a patient who had a preexisting, clinically silent, and unrecognized unilateral vocal cord paralysis from a remote cardiac surgical procedure. The patient, a 41-year-old woman who developed acute respiratory stridor and respiratory insufficiency at the time of extubation after undergoing a C6–7 ACD/F, required emergency reintubation and ventilation. Otolaryngological evaluation revealed bilateral vocal cord paralysis with one vocal cord showing evidence of acute paralysis and the other showing evidence of chronic paralysis. She eventually required a permanent tracheotomy. The patient had undergone previous cardiac surgical procedures to correct Fallot's tetralogy as a neonate and as a child. At those times, there were no recognized symptoms of transient or permanent vocal cord dysfunction. This case emphasizes the importance of identifying patients with preexisting unilateral vocal cord paralysis before performing neurosurgical procedures such as ACD/F, which can place the only functioning vocal cord at risk for paralysis. Guidelines for identifying patients with preexisting unilateral vocal cord paralysis and for modifying the surgical procedure for ACD/F to prevent the catastrophic complication of bilateral vocal cord paralysis are discussed.

Anterior cervical discectomy without bone graft

1977 ◽  
Vol 47 (4) ◽  
pp. 551-555 ◽  
Author(s):  
Donald H. Wilson ◽  
Dwight D. Campbell
Keyword(s):  
Bone Graft ◽  
Bone Grafting ◽  
Anterior Cervical Discectomy ◽  
Cervical Disc ◽  
Content Type ◽  
Cervical Discectomy ◽  
Without Bone Graft ◽  
Fine Print

✓ Anterior cervical discectomy without bone grafting may become the procedure of choice for acute cervical disc protrusions. This operation was performed on 71 patients, all of whom were followed from 1 to 6 years. Complications were minor in nature. The results were excellent and sustained.

Anterior cervical discectomy without interbody bone graft

1972 ◽  
Vol 37 (1) ◽  
pp. 71-74 ◽  
Author(s):  
Michael G. Murphy ◽  
Mokhtar Gado
Keyword(s):  
Bone Graft ◽  
Clinical Result ◽  
Anterior Cervical Discectomy ◽  
Incomplete Fusion ◽  
Cervical Disc ◽  
Content Type ◽  
Cervical Discectomy ◽  
Good Clinical Result ◽  
Fine Print

✓ Twenty-six patients had anterior cervical discectomy without interbody bone graft for lateral cervical disc syndrome. Twenty-four (92%) had a good clinical result. Radiological follow-up was obtained in 20 cases. The incidence of fusion was 72% for discectomy at a single level. Patients undergoing discectomy at two adjacent levels were too few to permit a statement regarding the incidence of fusion. In those cases of incomplete fusion, dynamic films demonstrated stability at the operated site. Half of the cases who had posterior osteophytes preoperatively showed some degree of resorption after 12 months. Neither incomplete fusion nor failure of osteophyte resolution was incompatible with a good clinical result.

Anterior cervical discectomy with and without fusion

1983 ◽  
Vol 59 (2) ◽  
pp. 252-255 ◽  
Author(s):  
Jarl Rosenørn ◽  
Elisabeth Bech Hansen ◽  
Mary-Ann Rosenørn
Keyword(s):  
Clinical Outcome ◽  
Randomized Study ◽  
Anterior Cervical Discectomy ◽  
Prospective Randomized Study ◽  
Herniated Disc ◽  
Content Type ◽  
Cervical Discectomy ◽  
Fine Print

✓ A prospective randomized study to compare discectomy without (DE) and with fusion (DEF) included 63 patients operated on for cervical herniated disc. The clinical outcome 3 and 12 months postoperatively was significantly better after DE than after DEF (p < 0.05). Significantly more patients operated on with DE returned to work during the first 9 weeks postoperatively than patients operated on with DEF (p < 0.005 to 0.05). The prognosis is significantly better for men than for women after DEF (p < 0.005), while no difference can be shown after DE.

Postoperative epidural hematoma as a complication of anterior cervical discectomy

1978 ◽  
Vol 49 (2) ◽  
pp. 288-291 ◽  
Author(s):  
U Hoi Sang ◽  
Charles B. Wilson
Keyword(s):  
Epidural Hematoma ◽  
Posterior Longitudinal Ligament ◽  
Anterior Cervical Discectomy ◽  
Content Type ◽  
Cervical Discectomy ◽  
Fine Print ◽  
Uncommon Complication

✓ In three cases, anterior cervical discectomy was complicated by acute postoperative paraplegia secondary to epidural hematomas at the operative sites. Prompt evacuation of the hematomas was followed by recovery in each instance. The source of bleeding was an arterial arcade that may be encountered during the course of removing the posterior longitudinal ligament. As a result of this experience, the authors suggest steps to be taken to avoid this uncommon complication.

Use of the operating microscope in anterior cervical discectomy without fusion

1975 ◽  
Vol 43 (4) ◽  
pp. 452-456 ◽  
Author(s):  
Hal L. Hankinson ◽  
Charles B. Wilson
Keyword(s):  
Bone Grafting ◽  
Anterior Cervical Discectomy ◽  
Long Term Results ◽  
Multiple Level ◽  
Operating Microscope ◽  
Content Type ◽  
Cervical Discectomy ◽  
Difficult Cases ◽  
Fine Print

✓ The authors report their experience using the operating microscope in 52 anterior cervical discectomies without fusion. They found long-term results highly satisfactory, even in difficult cases with multiple-level disease, and complications from bone grafting were obviated. They highly recommend this approach for radicular, nonradicular, or myelopathic symptoms.

Implantation of an empty carbon fiber composite frame cage after single-level anterior cervical discectomy in the treatment of cervical disc herniation: preliminary results

2003 ◽  
Vol 98 (2) ◽  
pp. 143-147 ◽  
Author(s):  
Michael Payer ◽  
Daniel May ◽  
Alain Reverdin ◽  
Enrico Tessitore
Keyword(s):  
Disc Herniation ◽  
Fiber Composite ◽  
Anterior Cervical Discectomy ◽  
Cervical Disc Herniation ◽  
Cervical Disc ◽  
Carbon Fiber Composite ◽  
Content Type ◽  
Cervical Discectomy ◽  
Fine Print

Object. The authors sought to evaluate retrospectively the radiological and clinical outcome of anterior cervical discectomy followed by implantation of an empty carbon fiber composite frame cage (CFCF) in the treatment of patients with cervical disc herniation and monoradiculopathy. Methods. Twenty-five consecutive patients (12 men, 13 women, mean age 45 years) with monoradiculopathy due to cervical disc herniation were treated by anterior cervical discectomy followed by implantation of an empty CFCF cage. On lateral flexion—extension radiographs segmental stability at a mean follow up of 14 months (range 5–31 months) was demonstrated in all 25 patients, and bone fusion was documented in 24 of 25 patients. The mean anterior intervertebral body height was 3.4 mm preoperatively and 3.8 mm at follow up in 20 patients. In these patients the mean segmental angle (angle between lower endplate of lower and upper vertebra) was 0.9° preoperatively and 3.1° at follow up. In the remaining five patients preoperative images were not retrievable. Self-scored neck pain based on a visual analog scale (1, minimum; 10, maximum) changed from a preoperative average of 5.6 to an average of 2 at follow up; radicular pain was reduced from 7.7 to 2.1 postoperatively. Analysis of the SF12 questionnaires showed a significant improvement in both the physical capacity score (preoperative mean 32.4 points; follow up 46 points) and the mental capacity score (preoperative mean 45.8 points; follow up 57.5 points). Conclusions. Implantation of an empty CFCF cage in the treatment of cervical disc herniation and monoradiculopathy avoids donor site morbidity associated with autologous bone grafting as well as the use of any supplementary material inside the cage. Restoration or maintenance of intervertebral height and thus segmental lordosis and a very high rate of segmental stability and fusion are achieved using this technique.

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