Anterior cervical fusion for radicular-disc conflict performed by three different procedures: clinical and radiographic analysis at long-term follow-up

Zagra, Antonino; Zagra, Luigi; Scaramuzzo, Laura; Minoia, Leone; Archetti, Marino; Giudici, Fabrizio

doi:10.1007/s00586-013-3006-z

Cited by 10 publications

(11 citation statements)

References 17 publications

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“…The present study is not the first study to use PEEK cages filled with commercially available granulated beta-TCP in an injectable form in ACDF; however, only a handful of reports were available. 15 , 29 , 30 , 31 , 32 Our results were consistent: results indicate that use of beta-TCP results in comparable fusion rates, and has the advantage of reduced morbidity associated with autogeneous grafts.…”

Section: Discussionsupporting

confidence: 76%

Anterior cervical fusion with interbody cage containing beta-tricalcium phosphate: Clinical and radiological results

Ofluoglu

Erdoğan

Aydoğan

et al. 2017

Acta Orthopaedica et Traumatologica Turcica

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AimBeta tricalcium phosphate (beta-TCP) is an osteoconductive, resorbable material. Its clinical effectiveness has been proved in many indications. This study was clinical and radiographic study report obtained in patients undergoing anterior cervical discectomy and fusion ACDF in which PEEK cages were filled beta-TCP in an injectable form.Material and methodsBetween January 2010 and June 2011, 16 consecutive patients underwent ACDF using PEEK cages with beta-TCP. The cohort compromised 10 men and 6 women with a mean age of 45.2 years. The surgery was performed when the patient had myelopathy or radiculopathy with progressive neurological deficit, or failure of conservative treatment (a minimum of 3 months). The patients were evaluated by Odom criteria preoperatively and postoperative 3rd, 6th, 12th and 24th months. Preop and postop pain was evaluated with visual analogue scala (VAS). Disc height and fusion success rates were evaluated.ResultsPreoperative average VAS score was 7.9 (7–10) for neck pain and 8 (7–10) for arm pain. At the final follow-up, these scores became 1.5 and 1.4 for neck and arm pain, respectively. The average improvement rate was 81% for neck pain and 82.5% for arm pain. Postop ODOM's criteria main rate was 3.4. Bone fusion was achieved in 14 segments (70%) at 3rd month, 19 segments (95%) at 12th month follow-up assessment.ConclusionClinical and radiological results revealed that B-TCP is a good alternative synthetic fusion material for cervical interbody fusion.Level of evidence: Level IV, therapeutic study.

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Section: Discussionsupporting

confidence: 76%

Anterior cervical fusion with interbody cage containing beta-tricalcium phosphate: Clinical and radiological results

Ofluoglu

Erdoğan

Aydoğan

et al. 2017

Acta Orthopaedica et Traumatologica Turcica

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“…A total of 153 articles were assessed by two independent reviewers for eligibility and finally 17 articles -5 prospective and 12 retrospectivewere included. [8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24] The search mechanism used in the review is shown in Figure 1.…”

Section: Resultsmentioning

confidence: 99%

Complications With Demineralized Bone Matrix, Hydroxyapatite and Beta-Tricalcium Phosphate in Single and Two-Level Anterior Cervical Discectomy and Fusion Surgery

Cabrera,

Muthu,

Mesregah

et al. 2024

Global Spine Journal

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Study Design Systematic literature review. Objectives To analyze the evidence available reporting complications in single or two-level anterior cervical discectomy and fusion (ACDF) using a demineralized bone matrix (DBM), hydroxyapatite (HA), or beta-tricalcium phosphate (β-TCP). Methods A systematic review of the literature using PubMed, EMBASE, Cochrane Library, and ClinicalTrials.gov databases was performed in August 2020 to identify studies reporting complications in one or two-level ACDF surgery using DBM, HA, or β-TCP. The study was reported following the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Results A total of 1857 patients were included, 981 male and 876 female, across 17 articles; 5 prospective, and 12 retrospectives. We noted heterogeneity among the included studies concerning the study design and combination of graft materials utilized in them. However, we noted a higher incidence of adjacent segment disease (17.7%) and pseudoarthrosis (9.3%) in fusion constructs using DBM. Studies using β-TCP reported a higher incidence of pseudoarthrosis (28.2%) and implant failures (17.9%). Conclusions Degenerative cervical conditions treated with one or two-level ACDF surgery using DBM, HA, or β-TCP with or without cervical plating are associated with complications such as adjacent segment disease, dysphagia, and pseudarthrosis. However, consequent to the study designs and clinical heterogeneity of the studies, it is not possible to correlate these complications accurately with any specific graft material employed. Further well-designed prospective studies are needed to correctly know the related morbidity of each graft used for achieving fusion in ACDF.

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“…In a study by Zagra et al, 59 33 patients underwent implantation of a stand-alone PEEK cage augmented with β-TCP and were compared with 2 other groups: (1) iliac autograft with plate fixation and (2) iliac graft with titanium cage. All patients achieved a solid fusion at the last follow-up.…”

Section: Tricalcium Phosphatementioning

confidence: 99%

“…Nevertheless, ACDF with PEEK cage and β-TCP was not only clinically effective but also resulted in a better fusion rate. 59 Sugawara et al 37 used cylindrical titanium cages packed with β-TCP in 57 patients and found no dislocation or material-related complications, in contrast to the study by Zagra et al 59 They reported that the fusion rate was significantly higher in the β-TCP compared with HA at 6-month (46% vs 24%) and 1-year follow-up (69% vs 49%); however, the fusion rate was similar between groups at 2-year follow-up (94% vs 90%). 37 Park and Roh 60 compared the efficacy of iliac autograft with PEEK cages filled with β-TCP.…”

Section: Tricalcium Phosphatementioning

confidence: 99%

Clinical Application of Ceramics in Anterior Cervical Discectomy and Fusion: A Review and Update

Zadegan

Abedi

Jazayeri

et al. 2017

Global Spine Journal

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Study Design:Narrative review.Objectives:Anterior cervical discectomy and fusion (ACDF) is a reliable procedure, commonly used for cervical degenerative disc disease. For interbody fusions, autograft was the gold standard for decades; however, limited availability and donor site morbidities have led to a constant search for new materials. Clinically, it has been shown that calcium phosphate ceramics, including hydroxyapatite (HA) and tricalcium phosphate (TCP), are effective as osteoconductive materials and bone grafts. In this review, we present the current findings regarding the use of ceramics in ACDF.Methods:A review of the relevant literature examining the clinical use of ceramics in anterior cervical discectomy and fusion procedures was conducted using PubMed, OVID and Cochrane.Result:HA, coralline HA, sandwiched HA, TCP, and biphasic calcium phosphate ceramics were used in combination with osteoinductive materials such as bone marrow aspirate and various cages composed of poly-ether-ether-ketone (PEEK), fiber carbon, and titanium. Stand-alone ceramic spacers have been associated with fracture and cracks. Metallic cages such as titanium endure the risk of subsidence and migration. PEEK cages in combination with ceramics were shown to be a suitable substitute for autograft.Conclusion:None of the discussed options has demonstrated clear superiority over others, although direct comparisons are often difficult due to discrepancies in data collection and study methodologies. Future randomized clinical trials are warranted before definitive conclusions can be drawn.

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Anterior cervical fusion for radicular-disc conflict performed by three different procedures: clinical and radiographic analysis at long-term follow-up

Abstract: As shown by the obtained clinical and radiographic results, the anterior interbody fusion with stand-alone peek cage containing β-tricalcium phosphate could be considered an effective and reliable procedure.

Cited by 10 publications

References 17 publications

Anterior cervical fusion with interbody cage containing beta-tricalcium phosphate: Clinical and radiological results

Anterior cervical fusion with interbody cage containing beta-tricalcium phosphate: Clinical and radiological results

Complications With Demineralized Bone Matrix, Hydroxyapatite and Beta-Tricalcium Phosphate in Single and Two-Level Anterior Cervical Discectomy and Fusion Surgery

Clinical Application of Ceramics in Anterior Cervical Discectomy and Fusion: A Review and Update

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