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 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, Fusion and stabilization by plate and screw–early experience

2012 ◽  
Vol 38 (2) ◽  
pp. 62-66 ◽  
Author(s):  
MA Islam ◽  
MA Islam ◽  
MA Habib ◽  
N Sakeb
Keyword(s):  
Anterior Cervical Discectomy ◽  
Cervical Disc ◽  
Cervical Discectomy ◽  
Hardware Failure ◽  
Operative Complications ◽  
Graft Extrusion ◽  
Anterior Cervical Discectomy Fusion ◽  
Cervical Plating ◽  
Medical University

Anterior cervical plating is commonly performed to stabilize anterior cervical fusion. The aim of the study was to evaluate the clinical and functional outcome, radiological fusion and operative complications in cases of cervical spondylotic myelopathy and radiculopathy who underwent Anterior Cervical Discectomy and Fusion (ACDF) by autograft and stabilized with plate and screw. We evaluated 16 consecutive patients (M: F=10:6) from January 2008 to December 2010 in Bangabandhu Sheikh Mujib Medical University (BSMMU) and different private hospitals in Dhaka, in cases where adequate conservative treatment failed. Single level ACDF by autograft and stabilization by plate and screw was done in 10 patients and 06 patients had two levels fusion. The mean follow up period was 18 months. The patients improved significantly (p<0.05) and the recovery rate was 87.50%. All patients showed radiological fusion (p<0.001). There was no hardware failure, graft extrusion or plate breakage. ACDF with plate and screw is fairly safe and effective therapy for cervical disc degeneration leading to myelo-radiculopathy where major post operative complications are uncommon. DOI: http://dx.doi.org/10.3329/bmrcb.v38i2.12884 Bangladesh Med Res Counc Bull 2012; 38: 62-66

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 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 Partial uncinatectomy combined with anterior cervical discectomy and fusion for the treatment of one-level cervical radiculopathy: analysis of clinical efficacy and sagittal alignment

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Haimiti Abudouaini ◽  
Tingkui Wu ◽  
Hao Liu ◽  
Beiyu Wang ◽  
Hua Chen ◽  
...  
Keyword(s):  
Clinical Efficacy ◽  
Sagittal Alignment ◽  
Cervical Radiculopathy ◽  
Fusion Rate ◽  
Uncinate Process ◽  
Anterior Cervical Discectomy ◽  
Cervical Discectomy ◽  
Cervical Sagittal Alignment ◽  
Uncovertebral Joint

Abstract Background Biomechanical studies have demonstrated that uncovertebral joint contributes to segment mobility and stability to a certain extent. Simultaneously, osteophytes arising from the uncinate process are a common cause of cervical spondylotic radiculopathy (CSR). For such patients, partial uncinatectomy (UT) may be required. However, the clinical efficacy and sagittal alignment of partial UT during anterior cervical discectomy and fusion (ACDF) have not been fully elucidated. Methods A total of 87 patients who had undergone single level ACDF using a zero-profile device from July 2014 to December 2018 were included. Based on whether the foraminal part of the uncovertebral joint was resected or preserved, the patients were divided into the ACDF with UT group (n = 37) and the ACDF without UT group (n = 50). Perioperative data, radiographic parameters, clinical outcomes, and complications were compared between the two groups. Results The mean follow-up was 16.86 ± 5.63 and 18.36 ± 7.51 months in the ACDF with UT group and ACDF without UT group, respectively (p > 0.05). The average preoperative VAS arm score was 5.89 ± 1.00 in the ACDF with UT group and 5.18 ± 1.21 in the ACDF without UT group (p = 0.038). However, the average VAS arm score was 4.22 ± 0.64, 4.06 ± 1.13 and 1.68 ± 0.71, 1.60 ± 0.70 at 1 week post operation and at final follow up, respectively, (p > 0.05). We also found that the C2-7 SVA and St-SVA at the last follow-up and their change (last follow-up value − preoperative value) in the ACDF with UT group were significantly higher than ACDF without UT group (p < 0.05). No marked differences in the other cervical sagittal parameters, fusion rate or complications, including dysphagia, ASD, and subsidence, were observed. Conclusions Our result indicates that ACDF using a zero-p implant with or without partial UT both provide satisfactory clinical efficacy and acceptable safety. However, additional partial UT may has a negative effect on cervical sagittal alignment.

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.

Pseudarthrosis in anterior cervical discectomy and fusion with a self-locking, stand-alone cage filled with hydroxyapatite: a retrospective study with clinical and radiological outcomes of 98 levels with a minimum 2-year follow-up

2020 ◽  
Vol 33 (6) ◽  
pp. 717-726
Author(s):  
Eduardo A. Iunes ◽  
Enrico A. Barletta ◽  
Telmo A. B. Belsuzarri ◽  
Franz J. Onishi ◽  
André Y. Aihara ◽  
...  
Keyword(s):  
Statistical Significance ◽  
Neck Disability Index ◽  
Wilcoxon Test ◽  
Anterior Cervical Discectomy ◽  
Adjacent Level ◽  
Disc Disease ◽  
Cervical Discectomy ◽  
Arm Pain ◽  
Pain Status

OBJECTIVEThe goal of this study was to evaluate the incidence of pseudarthrosis after the treatment of cervical degenerative disc disease (CDDD) with anterior cervical discectomy and fusion (ACDF) in which self-locking, stand-alone intervertebral cages filled with hydroxyapatite were used.METHODSThe authors performed a retrospective cohort study of 49 patients who underwent 1- to 3-level ACDF with self-locking, stand-alone intervertebral cages without plates, with a minimum 2 years of follow-up. The following data were extracted from radiological and clinical charts: age, sex, time and type of pre- and postoperative signs and symptoms, pain status (visual analog scale [VAS]), functional status (Neck Disability Index [NDI]), history of smoking, bone quality (bone densitometry), and complications. Pseudarthrosis was diagnosed by a blinded neuroradiologist using CT scans. Clinical improvement was assessed using pre- and postoperative comparison of VAS and NDI scores. The Wilcoxon test for paired tests was used to evaluate statistical significance using a p value of < 0.05.RESULTSThree patients (6%) developed symptomatic pseudarthrosis requiring reoperation, with only 1 patient showing clinical worsening due to pseudarthrosis, while the other 2 with pseudarthrosis had associated disc disease at an adjacent level. The rate of symptomatic pseudarthrosis according to the number of operated levels was 0% for 1 level, 8.7% (2/23 patients) for 2 levels, and 7.7% (1/13 patients) for 3 levels. The total pseudarthrosis rate (including both symptomatic and asymptomatic patients) was 16.4%. Considering the clinical outcomes, there was a significant improvement of 75.6% in neck pain and 95.7% in arm pain, as well as a 64.9% improvement in NDI scores. Complications were observed in 18.4% of patients, with adjacent-level degenerative disease being the most prevalent at 14.3%.CONCLUSIONSACDF with self-locking, stand-alone cages filled with a hydroxyapatite graft can be used for the surgical treatment of 1- to 3-level CDDD with clinical and radiological outcomes significantly improved after a minimum 2-year follow-up period. Comparative studies are necessary.

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.

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