scholarly journals Comparison between anterior cervical discectomy with fusion by polyetheretherketone cages and tricortical iliac-crest graft for the treatment of cervical prolapsed intervertebral disc

2016 ◽  
Vol 9 (3) ◽  
pp. 169
Author(s):  
Md. Anowarul Islam ◽  
Md. Masud Rana ◽  
Md. Fahad Goni ◽  
Md. Naimur Rahman
Keyword(s):  
Iliac Crest ◽  
Donor Site ◽  
Fusion Rate ◽  
Anterior Cervical Discectomy ◽  
Peek Cage ◽  
Iliac Crest Graft ◽  
Cervical Discectomy ◽  
Arm Pain ◽  
Significant Difference ◽  
Cage Group

<p>Anterior cervical discectomy with fusion (ACDF) is challenging in relation to the choice of surgical procedure.  The objective of this study was to evaluate the clinical outcome of ACDF with  tricor-tical iliac crest graft (ICG) and plate screw in comparision to fusion with  polyetheretherketone (PEEK) cages filled with autologous iliac crest graft. Forty patients (males 24; females 16 with mean age 45 ± 8.3 years) were randomly divided into two treatment groups (PEEK cage and ICG). Clinical assessment was done using Nurick scale for myelopathy, Odom's criteria for functional outcome and Visual Analogue Scale (VAS) for both neck and arm pain. Seventeen patients were operated for single-level discectomy and fusion by either PEEK cages or ICG. Another 23 patients were operated for two-levels. There were significant postoperative improvements of  Nurick scale and VAS during follow-up (after 2 years). According to Odom criteria, 18 patients (90%) were graded excellent in the PEEK cage group compared to 16 patients (85%) in the group with ICG group (statistically not significant). A significant difference (p&lt;0.02) was found in VAS for arm pain after 24 months with less pain in the cage group. Fusion occurred in 17 patients (85%) of the PEEK cage group and 18 patient (90%) of the ICG group. In conclusion, the PEEK cage is superior for fusion rate but the ICG is lack of donor site morbidity.</p><p> </p>

scholarly journals In Spondylotic Cervical Myelopathy Anterior Cervical Discectomy and Fusion by Peek Cage Without Plate Reinforcement is a Standard Method of Treatment

2017 ◽  
Vol 25 (2) ◽  
pp. 110-114
Author(s):  
Md Anowarul Islam ◽  
Qamruzzaman Parvez ◽  
SK Sarker ◽  
Md Fahad Goni ◽  
Md Masud Rana
Keyword(s):  
Clinical Outcome ◽  
Cervical Myelopathy ◽  
Donor Site ◽  
Fusion Rate ◽  
Anterior Cervical Discectomy ◽  
Peek Cage ◽  
Cervical Discectomy ◽  
Medical College ◽  
Arm Pain ◽  
Medical University

Background: Anterior cervical discectomy with fusion (ACDF) is challenging with respect to both patient selection and choice of surgical procedure.Objective: The aim of this study was to evaluate the clinical outcome of anterior cervical discectomy and fusion with an artificial cage made of polyetheretherketone .Patients and Methods: From January 2012 to January 2016, 40 consecutive patients referred to the Department of spine surgery, Bangabandhu Shekh Mujib Medical University were recruited for the study.Postoperative Clinical outcome assessd 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: 18 patients were operated for one level discectomy and fusion with PEEK cages and 22 patients for two levels. There were 24 (60%) males and 16 (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, 36/40 patients (90%) were graded excellentgood.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.J Dhaka Medical College, Vol. 25, No.2, October, 2016, Page 110-114

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

Does smoking have an impact on fusion rate in single-level anterior cervical discectomy and fusion with allograft and rigid plate fixation?

2013 ◽  
Vol 19 (5) ◽  
pp. 527-531 ◽  
Author(s):  
Myles Luszczyk ◽  
Justin S. Smith ◽  
Jeffrey S. Fischgrund ◽  
Steven C. Ludwig ◽  
Rick C. Sasso ◽  
...  
Keyword(s):  
Plate Fixation ◽  
Fusion Rate ◽  
Anterior Cervical Discectomy ◽  
Cervical Disc ◽  
Cervical Discectomy ◽  
Single Level ◽  
Significant Difference ◽  
Solid Fusion ◽  
Cervical Plate ◽  
Anterior Cervical Plate

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.

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

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.

scholarly journals Outcome of Anterior Cervical Discectomy and Fusion for Cervical Spondylotic Myelopathy

2019 ◽  
Vol 9 (2) ◽  
pp. 133-137
Author(s):  
Apel Chandra Saha ◽  
Md Hasan Masud
Keyword(s):  
Cervical Spondylotic Myelopathy ◽  
Cervical Spinal Cord ◽  
Donor Site ◽  
Fusion Rate ◽  
Donor Site Morbidity ◽  
Anterior Cervical Discectomy ◽  
Common Procedure ◽  
Cervical Discectomy ◽  
Operative Complications ◽  
Before And After

Background: Cervical spondylotic myelopathy (CSM) is a progressive degenerative disease and the most common cause of cervical spinal cord dysfunction (SCD) in older patients. Anterior cervical discectomy andfusion (ACDF) is a common procedure for patients with severe neurological deterioration. The goals of this study were to evaluate the clinical and functional outcome, radiological fusion and operative complications in case of CSM who underwent ACDF by autogeneous-tricortical bone graft and stabilized with plate and screws. Methods: This prospective interventional study was carried out at National Institute of Traumatology and Orthopaedic Rehabilitation ( NITOR) and different private hospitals in Dhaka from January 2012 to December 2014. Within this period total 12 CSM patients were included as study sample. All were surgically treated by ACDF and stabilized by plate and screws. All patients were clinically and radiologically evaluated before and after surgery. Results: Single level ACDF by autograft and stabilization by plate and screws was done in 10 (83.33%) patients and 2 (16.67%) patients had two level fusion. The mean follow up period was 12 months. The satisfactory result was found in 10 (83.33%) patients. Post-operative complications were donor site morbidity in2 (16.67%) patients and transient dysphagia in 1 (8.33%) patient. The fusion rate was 100% in this series. Conclusion: ACDF with anterior plating for CSM is a safe and effective procedure. It results in highest fusion, least complication and relatively lower cost. Birdem Med J 2019; 9(2): 133-137

scholarly journals Comparison of Recombinant Human Bone Morphogenetic Protein-2 versus Iliac Crest Autograft in Anterior Cervical Discectomy and Fusion

2020 ◽  
Author(s):  
Jinhui Shi ◽  
Yonghui Huang ◽  
Sheng Song ◽  
Feng Yuan ◽  
Gang Liu ◽  
...  
Keyword(s):  
Low Dose ◽  
Iliac Crest ◽  
Anterior Cervical Discectomy ◽  
Bone Morphogenetic Protein 2 ◽  
Preoperative Pain ◽  
Cervical Discectomy ◽  
Morphogenetic Protein ◽  
Significant Difference ◽  
Human Bone Morphogenetic Protein ◽  
Bone Autograft

Abstract Backgroud The use of rhBMP-2 in anterior cervical discectomy and fusion (ACDF) is still “off-label” therapy because of higher incidence of potential complications such as adverse swelling, dysphagia, and airway compromise. The purpose of this study is to investigate whether the low dose rhBMP-2 (0.5 mg/level) decreases the incidence and severity of local complications in ACDF. Methods 173 consecutively patients from June 2015 to March 2016 at seven participating centers in the China were enrolled. All the patients had primary one- or two-level ACDF with either rhBMP-2(BMP, n=110) or iliac-crest bone autograft (IGB, n=63) were analyzed. Patients in both groups had compared preoperative pain and disability. The follow up timing was postoperative third days, postoperative-1, 3, 6 and 12 months. Results Patient demographics have no significantly difference between the BMP group and IGB group pre-operation (P>0.05). No significant difference in overall dysphagia incidence between the two groups (p > 0.05). There was significant difference of PSTS at C3 level between two groups at all interval time (P<0.01). There was significant difference of PSTS at C6 level at postoperative third days (P<0.01) and 3 months (0.010.05). No pseudarthrosis in both Groups. No significant difference in VAS scores, JOA and NDI .scores between two groups (P>0.05). Conclusion The adverse events associated with low dose rhBMP-2 for one- and two-level ACDF are rare. We recommend placing the rhBMP-2 carrier in the center of cage, and bilateral coverage of the carrier with excised local osteophytes.

scholarly journals Preliminary outcomes of allograft and hydroxyapatite as substitutes for autograft in anterior cervical discectomy and fusion with self-locking standalone cages

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Changsheng Yang ◽  
Wentao Zhuo ◽  
Qingchu Li ◽  
Caiqiang Huang ◽  
Huibo Yan ◽  
...  
Keyword(s):  
Clinical Efficacy ◽  
Donor Site ◽  
Fusion Rate ◽  
Iliac Bone ◽  
Anterior Cervical Discectomy ◽  
Allogeneic Bone ◽  
Cervical Discectomy ◽  
Cage Subsidence ◽  
Group A ◽  
Group B

Abstract Purpose To investigate the efficacy and safety of allograft and hydroxyapatite (HA) as substitutes for autograft in anterior cervical discectomy and fusion (ACDF). Methods In this study, 49 patients (80 segments) treated with ACDF were included and allocated into three groups [group A, autogenous iliac bone, n = 18; group B, allogeneic bone, n = 16; group C, HA, n = 15]. The clinical efficacy and fusion status were compared among each group. Complications were recorded in detail, and the Bazaz classification and Voice Handicap Index-10 (VHI-10) were used to detect dysphagia and dysphonia. Results Patients exhibited similar clinical efficacy among the groups during the final follow-up. All patients in groups A and B achieved fusion compared to only 73.3% of patients in group C. Groups A and B had similar fusion score, both of which greater than that of group C. No cage subsidence was observed in group A; however, 6.3% of patients in group B and 53.3% in group C had cage subsidence. Two patients in group A (11.1%) had persistent pain at the donor site. One patient in group B had dysphagia and dysphonia (6.3%), while one patient in group C had dysphonia (6.7%). Conclusion In ACDF, the autogenous iliac bone was the most ideal bone graft. The allogeneic bone was an acceptable substitute but risked cage subsidence and dysphagia. HA had a much lower fusion rate and a high risk of cage subsidence. Better substitutes should be further explored for ACDF.

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.

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