Study Design
A retrospective review of patients who underwent 2-level anterior cervical discectomy and fusion (ACDF) with standalone polyetheretherketone (PEEK) cages for cervical spondylotic myelopathy (CSM).
Purpose
To evaluate the efficacy of stand-alone PEEK cage in 2-level cervical interbody fusion for CSM.
Overview of Literature
ACDF is a standard surgical procedure to treat degenerative disc disease. However, the use of additional anterior plating for 2-level ACDF remains controversial.
Methods
We reviewed outcomes of patients who underwent 2-level ACDF with stand-alone PEEK cages for CSM over a 7-year period (2007–2015) in a regional hospital. Japanese Orthopaedic Association (JOA) score, fusion rate, subsidence rate, cage migration, and cervical alignment by the C2–7 angle as well as the local segmental angle (LSA) of the cervical spine were assessed.
Results
In total, 31 patients (mean age, 59 years; range, 36–87 years) underwent 2-level ACDF with a cage-only construct procedure between 2007 and 2015. The minimum follow-up was 24 months; mean follow-up was 51 months. C3–5 fusion was performed in 45%, C4–6 fusion in 32%, and C5–7 fusion in 23%. Mean JOA score improved from 10.1±2.2 to 13.9±2.1 (
p
<0.01) at the 24-month follow-up. Fusion was achieved in all patients. Subsidence occurred in 22.5% of the cages but was not associated with differences in JOA scores, age, sex, or levels fused. Lordosis of the C2–7 angle and LSA increased after surgery, which were maintained for up to 1 year but subsequently disappeared after 2 years, yet the difference was not statistically significant. No cage migration was noted; two patients developed adjacent segment disease requiring posterior laminoplasty 3 years after ACDF.
Conclusions
The use of a stand-alone PEEK cage in a 2-level cervical interbody fusion achieves satisfactory improvements in both clinical outcomes and fusion.
Background
There has been limited literature regarding the influence of hamstring autograft diameter on the outcome of anterior cruciate ligament (ACL) reconstruction in Asian population. This study was undertaken to investigate the failure rate after ACL reconstruction among Chinese patients treated with hamstring tendon autografts of different diameters. Our hypothesis was that an increase in hamstring tendon autograft diameter would reduce the risk of graft failure.
Methods
A retrospective review of 394 consecutive patients who underwent ACL reconstruction using quadrupled semitendinous and gracillis autografts from 2009 to 2018 at our centre was performed. Logistic regression analysis was used to determine the relationship between graft failure rate and predictor variables, including hamstring graft diameter, gender and age.
Results
Hamstring graft diameter of 8.0 mm or more was found to be associated with significant reduction of risk in graft failure rate (P = 0.001, Relative Risk 0.19). No significant association was found between graft failure rate and gender or age.
Conclusion
Hamstring graft diameter 8.0 mm or greater is associated with decreased graft failure rate and revision rate in our local Chinese population.
The thenar eminence is made up of the intrinsic muscles of the hand that are responsible for complex movement and finite motor functions of the hand. The wasting of these muscles can be associated with various clinical conditions. Cavanagh syndrome is a rare, isolated congenital thenar hypoplasia with characteristic clinical, radiological, and electrophysiological features. Congenital absence of the radial artery is a rare anatomic variant. We report a case of a boy with isolated right-sided congenital thenar hypoplasia meeting the clinical and radiological characteristics of Cavanagh syndrome with concurrent absence of the right radial artery.
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