Follow-up of a new titanium-coated polyetheretherketone cage for the cervical spine

Poly-ether-ether-ketone (PEEK) cages have lower modulus of elasticity when compared with Titanium (TTN) cages. This suggests that PEEK-cages could show a lower rate of subsidence after anterior cervical discectomy-fusion (ACDF) and might lead to a lower loss of correction. We investigated the one to five year-results of standalone PEEK-TTN-porous coated cages in a patient cohort from 2014 to 2017. The patients underwent single-level ACDF for disc herniation and degenerative discopathy. Clinical and radiological outcome were assessed in 50 eligible patients after a mean of 27 months. Results: Solid arthrodesis was found in 84%. Neck disability index (NDI), and visual analogue scale (VAS) of neck and arm show comparable results to the literature. Conclusions: Clinical and radiological outcomes of ACDF with PEEK-body-cages with a porous coated surface show good bony integration. The modulus of elasticity, design, shape, size, cage surface architecture, as well as bone density, endplate preparation, radical microdiscectomy and distraction during surgery should be considered as important factors influencing the clinical results. One main advantage, over titanium cages, is the absence of MRI artifacts, allowing an excellent postoperative follow-up.

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Transcorporeal cervical foraminotomy: description of technique and results

Coluna/Columna ◽

10.1590/s1808-18512014130300r78 ◽

2014 ◽

Vol 13 (3) ◽

pp. 180-184

Author(s):

Guilherme Pereira Corrêa Meyer ◽

Gun Choi ◽

Amit Bandharkar ◽

Pil Sun Choi ◽

Sang Ho Lee ◽

...

Keyword(s):

Surgical Technique ◽

Analogue Scale ◽

Neck Disability Index ◽

Clinical Results ◽

Disc Height ◽

Significant Clinical Improvement ◽

Clinical Records ◽

Neck Disability ◽

Cervical Foraminotomy

OBJECTIVE: Retrospective analyses of 216 patients undergoing foraminal decompression with transcorporeal approach and review of the surgical technique. METHOD: 216 patients with minimum follow-up of 2 years and an average of 41.8 months were included in the study. The clinical records of these patients were reviewed for complications, NDI (neck disability index) and VAS (visual analogue scale). Pre and post-operative radiographs were used to evaluate the disc height. RESULTS: At the end of follow-up patients had significant clinical improvement with reduction of NDI of 88.3% and 86.5% and 68.3% of the VAS for neck and upper limb, respectively (p<0.05). A reduction of 8.8% of the disc height was observed without other complications associated (p<0.05). CONCLUSION: Radicular decompression through a transcorporeal approach is an alternative that provides good clinical results without the need for a fusion and with few complications.

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A Long-Term Control Study of the Treatment of Cervical Radiculopathy by Percutaneous Endoscopic Posterior Cervical Discectomy and Anterior Cervical Decompression, Bone Graft Fusion and Internal Fixation

10.21203/rs.3.rs-78852/v1 ◽

2020 ◽

Author(s):

Xiaodong Huang ◽

Weiheng Wang ◽

Qingxi Meng ◽

Jiangming Yu ◽

Xiaojian Ye

Keyword(s):

Clinical Symptoms ◽

Neck Disability Index ◽

Cervical Radiculopathy ◽

Clinical Results ◽

Cervical Discectomy ◽

Anterior Cervical Decompression ◽

Intermediate Outcomes ◽

Significant Difference ◽

Neck Disability

Abstract BackgroundCervical spondylotic radiculopathy (CSR) is very common all over the world. However, there are only a few reports about the efficacy of percutaneous endoscopic posterior cervical discectomy (PEPCD) in the treatment of CSR. Anterior cervical decompression and fusion (ACDF) and PEPCD which is a better way to treat CSR need further study.MethodsFrom January 2015 to December 2016. A retrospective study of 70 patients undergoing surgery for CSR (33 using PEPCD and 37 using ACDF). The intra-operative parameters, neck disability index (NDI), neck and arm visual analog scale (VAS) score were used to assessed clinical outcome. Radiological outcomes were assessed by measuring cervical 2-7 (C2-7) lordosis, disc height index (DHI), and degree of degenerative changes at the corresponding level.ResultsThe mean follow-up period was 48.5 month (36 –66 months). Two groups can significantly improve the clinical symptoms. There was no significant difference between the two groups in clinical results (VAS, NDI). Compared with preoperative, the lordosis of C2-7 increased significantly at the last follow-up. At the last follow-up, C2-7 lordosis in the ACDF group was significantly higher than that in the PEPCD group. In PEPCD, compared with preoperative, there was no significant difference in the DHI, but the degree of disc degeneration was significantly increased at the last follow-up.ConclusionFor patients with CSR, PEPCD had similar clinical early and intermediate outcomes when compared with ACDF, with the advantages of minimally invasive. PEPCD is a sufficient and safe supplement and alternative to conventional surgery.

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Motion-Preserving Navigated Primary Internal Fixation of Unstable C1 Fractures

Asian Spine Journal ◽

10.31616/asj.2019.0189 ◽

2020 ◽

Vol 14 (4) ◽

pp. 466-474

Author(s):

Shanmuganathan Rajasekaran ◽

Dilip Chand Raja Soundararajan ◽

Ajoy Prasad Shetty ◽

Rishi Mugesh Kanna

Keyword(s):

Neck Disability Index ◽

Optimal Placement ◽

Range Of Movement ◽

Ct Guided ◽

Duration Of Surgery ◽

The Mean ◽

The Right ◽

Neck Disability ◽

Displaced Fracture

Study Design: Prospective observational study.Purpose: To assess the safety, efficacy, and benefits of computed tomography (CT)-guided C1 fracture fixation.Overview of Literature: The surgical management of unstable C1 injuries by occipitocervical and atlantoaxial (AA) fusion compromises motion and function. Monosegmental C1 osteosynthesis negates these drawbacks and provides excellent functional outcomes.Methods: The patients were positioned in a prone position, and cranial traction was applied using Mayfield tongs to restore the C0–C2 height and obtain a reduction in the displaced fracture fragments. An intraoperative, CT-based navigation system was used to enable the optimal placement of C1 screws. A transverse rod was then placed connecting the two screws, and controlled compression was applied across the fixation. The patients were prospectively evaluated in terms of their clinical, functional, and radiological outcomes, with a minimal follow-up of 2 years.Results: A total of 10 screws were placed in five patients, with a mean follow-up of 40.8 months. The mean duration of surgery was 77±13.96 minutes, and the average blood loss was 84.4±8.04 mL. The mean combined lateral mass dislocation at presentation was 14.6±1.34 mm and following surgery, it was 5.2±1.64 mm, with a correction of 9.4±2.3 mm (<i>p</i> <0.001). The follow-up CT showed excellent placement of screws and sound healing. There were no complications and instances of AA instability. The clinical range of movement at 2 years in degrees was as follows: rotation to the right (73.6°±9.09°), rotation to the left (71.6°±5.59°), flexion (35.4°±4.5°), extension (43.8°±8.19°), and lateral bending on the right (28.4°±10.45°) and left (24.8°±11.77°). Significant improvement was observed in the functional Neck Disability Index from 78±4.4 to 1.6±1.6. All patients returned to their occupation within 3 months.Conclusions: Successful C1 reduction and fixation allows a motion-preserving option in unstable atlas fractures. CT navigation permits accurate and adequate monosegmental fixation with excellent clinical and radiological outcomes, and all patients in this study returned to their preoperative functional status.

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McKENZIE NECK EXERCISE LEBIH BAIK DALAM MENURUNKAN DISABILITAS LEHER DARIPADA DYNAMIC NECK EXERCISE PADA PENJAHIT DENGAN MYOFASCIAL PAIN SYNDROME OTOT UPPER TRAPEZIUS

Sport and Fitness Journal ◽

10.24843/spj.2020.v08.i02.p05 ◽

2020 ◽

Vol 8 (2) ◽

pp. 41

Author(s):

Boki Jaleha ◽

I Putu Gede Adiatmika ◽

Sugijanto Sugijanto ◽

I Made Muliarta ◽

Ketut Tirtayasa ◽

...

Keyword(s):

Myofascial Pain ◽

Neck Disability Index ◽

Pain Syndrome ◽

Myofascial Pain Syndrome ◽

T Test ◽

Upper Trapezius ◽

Paired Samples ◽

Post Test ◽

Neck Disability

Pendahuluan: Myofascial pain syndrome otot upper trapezius merupakan gangguan muskuloskeletal pada otot upper trapezius akibat penggunaan otot secara berlebihan, postur yang jelek, dan repetitif mikrotrauma sehingga menyebabkan nyeri, taut band, kelemahan otot dan disabilitas pada daerah leher. Tujuan Penelitian: Untuk mengetahui perbedaan efek kedua intervensi, Mckenzie Neck Exercise dan Dynamic Neck Exercise dalam menurunkan disabilitas leher pada penjahit dengan myofascial pain syndrome otot upper trapezius. Metode: Penelitian eksperimental ini menggunakan rancangan randomized pre and post test two group design. Sampel penelitian sebanyak 18 orang yang dibagi secara acak menjadi 2 kelompok, masing-masing kelompok berjumlah 9 orang. Kelompok I diberikan McKenzie Neck Exercise sedangkan Kelompok II diberikan Dynamic Neck Exercise. Perlakuan dilakukan 3 kali seminggu selama 6 minggu dengan evaluasi menggunakan kuesioner penilaian Neck Disability Index (NDI). Hasil: Hasil uji statistik menggunakan paired-samples t test pada Kelompok I dengan rerata skor sebelum intervensi (23,8±2,1)% dan sesudah intervensi yaitu (16,4±2,4)% dengan nilai (p < 0,05) dan Kelompok II dengan rerata skor sebelum intervensi (23,6±2,2)% dan sesudah intervensi (20,9±2,3)% dengan nilai (p < 0,05). Uji beda hipotesis antara Kelompok I dengan Kelompok II menggunakan independent-samples t test diperoleh nilai (p < 0,05). Simpulan: McKenzie Neck Exercise lebih baik dalam menurunkan disabilitas leher daripada Dynamic Neck Exercise dengan myofascial pain syndrome otot upper trapezius. Saran: Penelitian selanjutnya diharapkan dapat mengontrol aktivitas pekerja dilingkungan kerja maupun tempat tinggal dan diperlukan adanya tindak lanjut ataupun pengawasan (follow up) sampel penelitian setelah berakhirnya program penelitian pada masing-masing sampel, untuk mengetahui hasil intervensi yang diberikan dapat memberikan efek jangka panjang.

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A comparison of minimally invasive posterior cervical decompression and open anterior cervical decompression and instrumented fusion in the surgical management of degenerative cervical myelopathy

Neurosurgical FOCUS ◽

10.3171/2016.3.focus1650 ◽

2016 ◽

Vol 40 (6) ◽

pp. E7 ◽

Cited By ~ 3

Author(s):

Syed F. Abbas ◽

Morgan P. Spurgas ◽

Benjamin S. Szewczyk ◽

Benjamin Yim ◽

Ashar Ata ◽

...

Keyword(s):

Minimally Invasive ◽

Clinical Outcomes ◽

Neck Disability Index ◽

Case Series ◽

Patient Characteristics ◽

Short Term ◽

Instrumented Fusion ◽

Minimally Invasive Surgical ◽

Neck Disability

OBJECTIVE Minimally invasive posterior cervical decompression (miPCD) has been described in several case series with promising preliminary results. The object of the current study was to compare the clinical outcomes between patients undergoing miPCD with anterior cervical discectomy and instrumented fusion (ACDFi). METHODS A retrospective study of 74 patients undergoing surgery (45 using miPCD and 29 using ACDFi) for myelopathy was performed. Outcomes were categorized into short-term, intermediate, and long-term follow-up, corresponding to averages of 1.7, 7.7, and 30.9 months, respectively. Mean scores for the Neck Disability Index (NDI), neck visual analog scale (VAS) score, SF-12 Physical Component Summary (PCS), and SF-12 Mental Component Summary (MCS) were compared for each follow-up period. The percentage of patients meeting substantial clinical benefit (SCB) was also compared for each outcome measure. RESULTS Baseline patient characteristics were well-matched, with the exception that patients undergoing miPCD were older (mean age 57.6 ± 10.0 years [miPCD] vs 51.1 ± 9.2 years [ACDFi]; p = 0.006) and underwent surgery at more levels (mean 2.8 ± 0.9 levels [miPCD] vs 1.5 ± 0.7 levels [ACDFi]; p < 0.0001) while the ACDFi patients reported higher preoperative neck VAS scores (mean 3.8 ± 3.0 [miPCD] vs 5.4 ± 2.6 [ACDFi]; p = 0.047). The mean PCS, NDI, neck VAS, and MCS scores were not significantly different with the exception of the MCS score at the short-term follow-up period (mean 46.8 ± 10.6 [miPCD] vs 41.3 ± 10.7 [ACDFi]; p = 0.033). The percentage of patients reporting SCB based on thresholds derived for PCS, NDI, neck VAS, and MCS scores were not significantly different, with the exception of the PCS score at the intermediate follow-up period (52% [miPCD] vs 80% [ACDFi]; p = 0.011). CONCLUSIONS The current report suggests that the optimal surgical strategy in patients requiring dorsal surgery may be enhanced by the adoption of a minimally invasive surgical approach that appears to result in similar clinical outcomes when compared with a well-accepted strategy of ventral decompression and instrumented fusion. The current results suggest that future comparative effectiveness studies are warranted as the miPCD technique avoids instrumented fusion.

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Anterior versus posterior approach to treat cervical spondylotic myelopathy, clinical and radiological results with long period of follow-up

SAGE Open Medicine ◽

10.1177/2050312118766199 ◽

2018 ◽

Vol 6 ◽

pp. 205031211876619 ◽

Cited By ~ 4

Author(s):

Ziad A Audat ◽

Mohammad D Fawareh ◽

Ahmad M Radydeh ◽

Moutasem M Obeidat ◽

Mohannad A Odat ◽

...

Keyword(s):

Surgical Treatment ◽

Cervical Spondylotic Myelopathy ◽

Neck Disability Index ◽

X Ray ◽

Local Score ◽

Radiological Results ◽

Group Ii ◽

Neck Disability ◽

Clinical And Radiological Results

Background: Cervical spondylotic myelopathy increases with age, but not all cases are symptomatic. It is usually diagnosed clinically and radiologically (X-ray and magnetic resonance imaging). Surgical treatment is indicated in severe symptomatic cases, while treatment controversy exists in the presence of less severe cases. Anterior and posterior approaches are generally used for decompression with no significant differences in the results of both. Methods: A total of 287 patients of cervical spondylotic myelopathy were treated at our hospital between January 2004 and December 2015. Only 140 patients were eligible for our study. They had at least 5 years of follow-up using full clinical scores and radiological evaluation. They were divided into two groups: group I with 73 patients (aged 23–79 years) underwent posterior decompression, lateral mass instrumentation, and fusion, while group II with 67 patients (aged 33–70 years) underwent anterior decompression, instrumentation, and fusion. Neck Disability Index, local score, and X-ray were used in the evaluation of the patients. Results: Preoperative mean ± standard deviation of Neck Disability Index of both the groups was 32.06 ± 6.33 and 29.88 ± 5.48, which improved in the last visit (>5 years) to 5.81 ± 7.39 and 2.94 ± 5.48 for groups I and II, respectively (p value <0.05). The local score of groups I and II was (P = 1, F = 21, G = 31, E = 19) and (P = 1, F = 12, G = 36, E = 18), which on discharge day improved to (P = 1, F = 4, G = 12, E = 55) and (P = 0, F = 3, G = 6, E = 58) at last follow-up, respectively. Fusion rate was nearly equal for both the groups during all the follow-up intervals and it was 91.1% and 91.7% in the last follow-up. Conclusion: There were no significant differences in the clinical and radiological results between the anterior and posterior approaches used in the surgical treatment of spondylotic cervical myelopathy. However, statistically significant results of Neck Disability Index of anterior approach were not clinically important and may be due to changes in the size and shape of the neck in group II.

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Surgical Strategy for the Management of Cervical Deformity Is Based on Type of Cervical Deformity

Journal of Clinical Medicine ◽

10.3390/jcm10214826 ◽

2021 ◽

Vol 10 (21) ◽

pp. 4826

Author(s):

Han Jo Kim ◽

Sohrab Virk ◽

Jonathan Elysee ◽

Christopher Ames ◽

Peter Passias ◽

...

Keyword(s):

Neck Disability Index ◽

Treatment Strategies ◽

Surgical Approaches ◽

Surgical Strategies ◽

Cervical Deformity ◽

Related Quality ◽

Health Related ◽

Neck Disability

Objectives: Cervical deformity morphotypes based on type and location of deformity have previously been described. This study aimed to examine the surgical strategies implemented to treat these deformity types and identify if differences in treatment strategies impact surgical outcomes. Our hypothesis was that surgical strategies will differ based on different morphologies of cervical deformity. Methods: Adult patients enrolled in a prospective cervical deformity database were classified into four deformity types (Flatneck (FN), Focal kyphosis (FK), Cervicothoracic kyphosis (CTK) and Coronal (C)), as previously described. We analyzed group differences in demographics, preoperative symptoms, health-related quality of life scores (HRQOLs), and surgical strategies were evaluated, and postop radiographic and HROQLs at 1+ year follow up were compared. Results: 90/109 eligible patients (mean age 63.3 ± 9.2, 64% female, CCI 1.01 ± 1.36) were evaluated. Group distributions included FN = 33%, FK = 29%, CTK = 29%, and C = 9%. Significant differences were noted in the surgical approaches for the four types of deformities, with FN and FK having a high number of anterior/posterior (APSF) approaches, while CTK and C had more posterior only (PSF) approaches. For FN and FK, PSF was utilized more in cases with prior anterior surgery (70% vs. 25%). For FN group, PSF resulted in inferior neck disability index compared to those receiving APSF suggesting APSF is superior for FN types. CTK types had more three-column osteotomies (3CO) (p < 0.01) and longer fusions with the LIV below T7 (p < 0.01). There were no differences in the UIV between all deformity types (p = 0.19). All four types of deformities had significant improvement in NRS neck pain post-op (p < 0.05) with their respective surgical strategies. Conclusions: The four types of cervical deformities had different surgical strategies to achieve improvements in HRQOLs. FN and FK types were more often treated with APSF surgery, while types CTK and C were more likely to undergo PSF. CTK deformities had the highest number of 3COs. This information may provide guidelines for the successful management of cervical deformities.

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Postoperative structured rehabilitation in patients undergoing surgery for cervical radiculopathy: a 2-year follow-up of a randomized controlled trial

Journal of Neurosurgery Spine ◽

10.3171/2018.12.spine181258 ◽

2019 ◽

Vol 31 (1) ◽

pp. 60-69 ◽

Cited By ~ 1

Author(s):

Anneli Peolsson ◽

Håkan Löfgren ◽

Åsa Dedering ◽

Birgitta Öberg ◽

Peter Zsigmond ◽

...

Keyword(s):

Controlled Trial ◽

Neck Disability Index ◽

Clinical Signs ◽

Cervical Radiculopathy ◽

Postoperative Rehabilitation ◽

Clinical Trial Registration ◽

Randomized Controlled ◽

Negative Side Effects ◽

Neck Disability

OBJECTIVEInformation about postoperative rehabilitation for cervical radiculopathy (CR) is scarce. The aim of this study was to investigate the additional benefits of structured postoperative rehabilitation (SPT), which was performed in all patients, compared with a pragmatic standard postoperative approach (SA), in which rehabilitation was used as needed and patients sought physiotherapy on their own without a referral, in patients with MRI evidence of disc herniation and concomitant clinical signs who underwent surgery for CR.METHODSPatients (n = 202) were randomized to receive SPT or SA. Included key variables in the present study were primary and selected secondary outcomes of a prospective randomized controlled multicenter study. The main outcome was the Neck Disability Index (NDI) score. The NDI score, pain variables, self-efficacy, and health-related quality of life were investigated at baseline and 3, 6, 12, and 24 months postoperatively.RESULTSSPT provided no additional benefits over SA (p = 0.08 to p = 0.99) at the postoperative 2-year follow-up. Both groups improved over time (p < 0.0001), with no reported adverse effects.CONCLUSIONSOne can conclude that SPT offered no additional benefits over SA; however, patients tolerated postoperative neck exercises without any negative side effects. These findings are important for the development of future active and neck-specific postoperative rehabilitation interventions for patients with CR.Clinical trial registration no.: NCT01547611 (clinicaltrials.gov)

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Posterior percutaneous full-endoscopic cervical discectomy under local anesthesia for cervical radiculopathy due to soft-disc herniation: a preliminary clinical study

Journal of Neurosurgery Spine ◽

10.3171/2018.1.spine17795 ◽

2018 ◽

Vol 29 (4) ◽

pp. 351-357 ◽

Cited By ~ 8

Author(s):

Quan Wan ◽

Daying Zhang ◽

Shun Li ◽

Wenlong Liu ◽

Xiang Wu ◽

...

Keyword(s):

Local Anesthesia ◽

Disc Herniation ◽

Clinical Success ◽

Neck Disability Index ◽

Cervical Radiculopathy ◽

Functional Improvement ◽

Promising Alternative ◽

Cervical Discectomy ◽

Neck Disability

OBJECTIVETo the authors’ knowledge, posterior percutaneous full-endoscopic cervical discectomy (PPFECD) has not been reported before as a procedure performed with patients under local anesthesia (LA). In this study, the authors report the outcomes of 25 patients treated by this technique, the surgical steps, and the procedure’s potential advantages.METHODSTwenty-five patients diagnosed with cervical radiculopathy due to soft-disc herniation (SDH) were treated by PPFECD. The intensities of arm and neck pain were measured using the visual analog scale (VAS) and the functional status was assessed using the Neck Disability Index (NDI) preoperatively and at 1, 3, 6, and 12 months postoperatively. Global outcome was also assessed using modified Macnab criteria, and outcomes were grouped as clinical success (excellent or good) and clinical failure (fair or poor). Complications were also recorded.RESULTSNo patient was lost to the follow-up. Significant and durable pain relief and cervical functional improvement were achieved postoperatively. Clinical success was achieved in 24 patients (96%), including 22 excellent and 2 good outcomes at the last follow-up. No serious complications occurred.CONCLUSIONSThe authors’ preliminary experience indicates that PPFECD under LA is a feasible and promising alternative for selected cases of cervical radiculopathy due to SDH, though the procedure’s effectiveness and safety still need confirmation from further studies.

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STAND-ALONE CERVICAL CAGE FOR CERVICAL RADICULOPATHY: A RETROSPECTIVE STUDY

(JOINTS) Journal Orthopaedi and Traumatology Surabaya ◽

10.20473/joints.v9i1.2020.17-21 ◽

2020 ◽

Vol 9 (1) ◽

pp. 17

Author(s):

I Ketut Martiana ◽

Reyner Valiant Tumbelaka

Keyword(s):

Neck Disability Index ◽

Cervical Radiculopathy ◽

Surgical Method ◽

Arm Pain ◽

Phone Calls ◽

Specific Muscle ◽

Muscle Groups ◽

Hospital Institution ◽

Neck Disability

Introduction: Cervical radiculopathy is a clinical condition characterized by unilateral arm pain, numbness and tingling in a dermatomal distribution in the hand, and weakness in specific muscle groups that can be treated with nonsurgical or surgical method. This study aims to evaluate the outcome of the stand-alone cervical cage surgical method for cervical radiculopathy in our hospital institution from 2013 to 2017Methods: This is a retrospective observational study on every patient who undergoes a stand-alone cervical cage for cervical radiculopathy in our hospital institution from 2013 to 2017. The study runs from December 2017 until April 2018. We evaluated the clinical outcome with the Neck Disability Index (NDI). The data were collected from medical records, and postoperative follow up is done by house visits, phone calls, and outpatient visits.Results: Five male and one female subjects with a mean age of 58 years old (45–65 years old) underwent the procedure; one patient passed away on three year postoperative due to other events not related to operation procedure; one patient could no longer be reached. Four patient has an increasing score of NDI postoperative. There is no postoperative complicationConclusion: Stand-alone cervical cage is an excellent treatment for cervical radiculopathy in our hospital institution from 2013 to 2017.

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