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

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>

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 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.

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.

Anterior cervical discectomy and fusion using polyetheretherketone (PEEK) cage

2021 ◽  
Vol 18 (2) ◽  
pp. 49-54
Author(s):  
Rajiv Jha
Keyword(s):  
Donor Site ◽  
Anterior Cervical Discectomy ◽  
Spinal Curvature ◽  
Cervical Disc ◽  
Grading System ◽  
Peek Cage ◽  
Disc Prolapse ◽  
Additional Time ◽  
Cervical Discectomy ◽  
Grade Ii

Introduction:There are ways to operate for herniated cervical disc starting from simple discectomy to artificial disc replacement. Materials and Methods:This is a prospective study of anterior cervical discectomy and fusion with polyetheretherketone (PEEK) age device conducted from January 2016 till September 2019. Age, sex ratio, the level of disc prolapses, symptoms, complications of surgery and the outcome was assessed.Neurological assessment was done pre-and postoperative as defined by Odom’s criteria and Ranawat et al grading system. Check x ray was done at 3 and 6 months. Results: The total number of cases was 82, predominantly males (62%). Disc prolapse due to degenerative disease was the most common case (68%). C5-6 was the most often disc prolapse level (40%), followed by C6-7 level (38%) with multiple level disc prolapse in 12%. Applying Ranawat grading system of neurological deficit; at presentation, majority were in Grade II (54%), followed by Grade IIIA (19%). Postoperatively there was a reduction in weakness from 54% to 16% in Grade II and from 19% to 8% for Grade IIIA. Majority had excellent and good outcome based on Odom’s criteria. The continuity of the graft and the adjacent spinal curvature was also assessed and there was more than 96% fusion rate. Conclusion:Use of local autograft with a PEEK cage hasbenefit of working within the same operative window as the ACDF, thus reducing the infection, bleeding, and pain risks that may be encountered with a second incision. It is very safe to use in single level or multilevel cervical disc prolapse and also saves additional time of harvesting graft from donor site.

scholarly journals PEEK Cages versus PMMA Spacers in Anterior Cervical Discectomy: Comparison of Fusion, Subsidence, Sagittal Alignment, and Clinical Outcome with a Minimum 1-Year Follow-Up

2014 ◽  
Vol 2014 ◽  
pp. 1-11 ◽  
Author(s):  
Jan-Helge Klingler ◽  
Marie T. Krüger ◽  
Ronen Sircar ◽  
Evangelos Kogias ◽  
Christoph Scholz ◽  
...  
Keyword(s):  
Clinical Outcome ◽  
Sagittal Alignment ◽  
Anterior Cervical Discectomy ◽  
Ct Scans ◽  
Peek Cage ◽  
Disc Disease ◽  
Cervical Discectomy ◽  
Bony Fusion ◽  
Sf 36

Purpose. To compare radiographic and clinical outcomes after anterior cervical discectomy in patients with cervical degenerative disc disease using PEEK cages or PMMA spacers with a minimum 1-year follow-up.Methods. Anterior cervical discectomy was performed in 107 patients in one or two levels using empty PEEK cages (51 levels), Sulcem PMMA spacers (49 levels) or Palacos PMMA spacers (41 levels) between January, 2005 and February, 2009. Bony fusion, subsidence, and sagittal alignment were retrospectively assessed in CT scans and radiographs at follow-up. Clinical outcome was measured using the VAS, NDI, and SF-36.Results. Bony fusion was assessed in 65% (PEEK cage), 57% (Sulcem), and 46% (Palacos) after a mean follow-up of 2.5 years. Mean subsidence was 2.3–2.6 mm without significant differences between the groups. The most pronounced loss of lordosis was found in PEEK cages (−4.1°). VAS was 3.1 (PEEK cage), 3.6 (Sulcem), and 2.7 (Palacos) without significant differences. Functional outcome in the PEEK cage and Palacos group was superior to the Sulcem group.Conclusions. The substitute groups showed differing fusion rates. Clinical outcome, however, appears to be generally not correlated with fusion status or subsidence. We could not specify a superior disc substitute for anterior cervical discectomy. This trial is registered withDRKS00003591.

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