Clinical and Functional Outcome of Cervical Degenerative Disc Disease after Operative Treatment at Dr. Soetomo General Hospital Surabaya In 2013-2018

Backgrounds: Cervical degenerative disc disease is a pathological change in the cervical associated with the degenerative process. Surgery is one of the therapeutic modalities in cases of cervical degenerative disc disease. Post-surgical clinical outcomes are needed to evaluate the results of the actions that have been taken. Methods: This study is an observational retrospective study to evaluate clinical and functional outcomes using Neck Disability Index & SF36 on cervical degenerative disc disease before and after surgery at Dr. Soetomo Hospital Surabaya in 2013-2018. Data is processed using SPSS and compared using the T-test. Results: A total of 12 patients with details of 8 male patients and four female patients who met the inclusion and exclusion criteria in this study. There was a significant decrease in the average NDI score (p = 0.05) before surgery (47.33) compared with after surgery (15.58). There was a significant increase in the average SF36 score (p< 0.05) before surgery (50.75) compared to after surgery (88.16). Conclusions: There is an increase in clinical and functional outcomes in patients with cervical degenerative disc disease who undergo operative treatment.

Titanium-interlayer mediated hydroxyapatite coating on polyetheretherketone: a prospective study in patients with single-level cervical degenerative disc disease

Background Currently, there are limited reports regarding investigation of the biological properties of polyetheretherketone (PEEK) coated with titanium (Ti) and hydroxyapatite (HA) in human. The objective of this study is to evaluate the in vivo response of the PEEK cages coated with Ti and HA versus uncoated PEEK cages after anterior cervical discectomy and fusion (ACDF) in patients with single-level cervical degenerative disc disease (CDDD). Methods Twenty-four patients with PEEK cages coated with Ti and HA (PEEK/Ti/HA group) were matched one-to-one with patients with uncoated PEEK cages (PEEK group) based on age, gender, and operative segment. All patients had been followed up for more than 2 years. Radiological assessments included intervertebral height (IH), C2-7 angle (C2-7a), segmental alignment (SA), and fusion rate. Clinical parameters included Visual Analogue Scale (VAS) and Japanese Orthopedic Association (JOA) scores. Results There was no statistical difference in SA, IH, and C2-7a between the two groups before and after surgery and all these parameters were restored postoperatively. The fusion rate of PEEK/Ti/HA group was significantly higher than PEEK group at 3-month post-operation (87.5% vs. 62.5%). At the last follow-up, the fusion rate of the both groups achieved 100%. The VAS and JOA scores were comparable between two groups and improved postoperatively. Conclusions In patients with single-level ACDF, PEEK cage coated with Ti and HA provided a higher fusion rate than uncoated PEEK cage at 3-month post-operation, while both two cages could achieve solid osseous fusion at the last follow up. Compared with the uncoated PEEK cage, PEEK/Ti/HA cage yielded similar favorable segmental and overall cervical lordosis, IH, and clinical outcomes after the surgery.

Anterior Cervical Microdiscectomy and Fusion using Stand-Alone Polyetheretherketone Cage: A Retrospective Study

Introduction: Anterior Cervical Discectomy and Fusion (ACDF) constitutes the standard mode of treatment for cervical disc herniation due to degeneration. Stand-alone cage can be considered as effective treatment for single and two level disc prolapse. Aim: To examine the clinical outcomes of ACDF using stand- alone Polyetheretherketone (PEEK) cage in a single centre. Materials and Methods: This retrospective study was conducted from July 2015 to Dec 2020 in 224 consecutive patients who underwent successful ACDF using self-locking stand-alone PEEK cage, study was done at Shri Dharmasthala Manjunatheshwara tertiary care hospital, Dharwad, Karnataka, India for radiculopathy or myelopathy due to cervical degenerative disc disease. Data analysis was done upto March 2021. The patients were analysed with Visual Analogue Scale (VAS) pain score for neck and arm pain and Nurick grade preoperatively and at 3 months postoperatively. Patients underwent preoperative and postoperative clinical, neurological evaluation. This study was statistically analysed using the Statistical Package for the Social Sciences (SPSS version 13.0) (IBM, Chicago, IL). Results: Out of 244, (73%)164 patients underwent single level ACDF and sixty (27%) two-level ACDF. The mean age of patients was 45.86±12.07. It included 146 (65.2%) males and 78 (34.8%) female patients. In this study, the mean VAS neck score preoperatively was 4.04 and at 3 months postoperatively was 1.66 which was statistically significant (p<0.001). Even in VAS arm scores, there was a statistical significant difference (p<0.001) between preoperative (7.25) and 3 months postoperative (1.63) scores. The mean Nurick grade preoperatively was 1.46 vs 0.40 postoperatively which was statistically significant (p<0.001). No implant related complications or adjacent level disease was noted. Conclusion: This study demonstrated that treatment of cervical degenerative disc disease by ACDF withstand alone PEEK cage is an effective and safe method.

Titanium-interlayer Mediated Hydroxyapatite Coating on Polyetheretherketone: A Prospective Study in Patients with Single-level Cervical Degenerative Disc Disease

Currently, there are limited reports regarding investigation of the biological properties of polyetheretherketone (PEEK) coated with titanium (Ti) and hydroxyapatite (HA) in human. The objective of this study is to evaluate the in vivo response of the PEEK cages coated with Ti and HA versus uncoated PEEK cages after anterior cervical discectomy and fusion (ACDF) in patients with single-level cervical degenerative disc disease (CDDD). Twenty-four patients with PEEK cages coated with Ti and HA (PEEK/Ti/HA group) were matched one-to-one with patients with uncoated PEEK cages (PEEK group) based on age, gender, and operative segment. All patients had been followed up for more than 2 years. Radiological assessments included intervertebral height (IH), C2-7 angle(C2-7a), segmental alignment (SA), and fusion rate. Clinical parameters included Visual Analogue Scale (VAS) and Japanese Orthopedic Association (JOA) scores. There was no statistical difference in SA, IH, and C2-7a between the two groups before and after surgery and all these parameters were restored postoperatively. The fusion rate of PEEK/Ti/HA group was significantly higher than PEEK group at 3-month post-operation (87.5% vs. 62.5%). At the last follow-up, the fusion rate of the both groups achieved 100%. The VAS and JOA scores were comparable between two groups and improved postoperatively. In conclusion, in patients with single-level ACDF, PEEK cage coated with Ti and HA provided a higher fusion rate than uncoated PEEK cage at 3-month post-operation, while both of the two cages could achieve solid osseous fusion at the last follow up. Compared with the uncoated PEEK cage, PEEK/Ti/HA cage yielded similar favorable segmental and overall cervical lordosis, IH, and clinical outcomes after the surgery.

Titanium-interlayer Mediated Hydroxyapatite Coating on Polyetheretherketone: A Prospective Study in Patients with Single-level Cervical Degenerative Disc Disease

Currently, there are limited reports regarding investigation of the biological properties of polyetheretherketone (PEEK) coated with titanium (Ti) and hydroxyapatite (HA) in human. The objective of this study is to evaluate the in vivo response of the PEEK cages coated with Ti and HA versus uncoated PEEK cages after anterior cervical discectomy and fusion (ACDF) in patients with single-level cervical degenerative disc disease (CDDD). Twenty-four patients with PEEK cages coated with Ti and HA (PEEK/Ti/HA group) were matched one-to-one with patients with uncoated PEEK cages (PEEK group) based on age, gender, and operative segment. All patients had been followed up for more than 2 years. Radiological assessments included intervertebral height (IH), C2-7 angle(C2-7a), segmental alignment (SA), and fusion rate. Clinical parameters included Visual Analogue Scale (VAS) and Japanese Orthopedic Association (JOA) scores. There was no statistical difference in SA, IH, and C2-7a between the two groups before and after surgery and all these parameters were restored postoperatively. The fusion rate of PEEK/Ti/HA group was significantly higher than PEEK group at 3-month post-operation (87.5% vs. 62.5%). At the last follow-up, the fusion rate of the both groups achieved 100%. The VAS and JOA scores were comparable between two groups and improved postoperatively. In conclusion, in patients with single-level ACDF, PEEK cage coated with Ti and HA provided a higher fusion rate than uncoated PEEK cage at 3-month post-operation, while both of the two cages could achieve solid osseous fusion at the last follow up. Compared with the uncoated PEEK cage, PEEK/Ti/HA cage yielded similar favorable segmental and overall cervical lordosis, IH, and clinical outcomes after the surgery.