Anterior cervical fusion with carbon fiber cage containing coralline hydroxyapatite: preliminary observations in 45 consecutive cases of soft-disc herniation

Agrillo, Umberto; Mastronardi, Luciano; Puzzilli, Fabrizio

doi:10.3171/spi.2002.96.3.0273

Cited by 47 publications

(46 citation statements)

References 21 publications

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“…The advantage would be that they could provide immediate stability and share the load on bone substitutes to prevent collapse. The results were comparable with those reported by some authors [1,6,16] who used other calcium phosphate ceramics. Additionally, the ample blood supply might be another reason for successful interbody fusion.…”

Section: Discussionsupporting

confidence: 82%

“…Interbody fusion cages have been developed to avoid the complications related to bone harvesting from the donor site while increasing immediate stability of the cervical spine after decompression and promoting bony fusion [3,12,17] Some authors [1,6] recommended the use of anterior cervical fusion with cage containing bone substitutes. Satisfactory results were obtained regarding the fusion rates although fusion was delayed as compared with that in a cage containing autograft [6].…”

Section: Introductionmentioning

confidence: 99%

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Anterior cervical fusion with interbody cage containing β-tricalcium phosphate augmented with plate fixation: a prospective randomized study with 2-year follow-up

Dai

Jiang

2008

Eur Spine J

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A variety of bone graft substitutes, interbody cages, and anterior plates have been used in cervical interbody fusion, but no controlled study was conducted on the clinical performance of b-tricalcium phosphate (b-TCP) and the effect of supplemented anterior plate fixation. The objective of this prospective, randomized clinical study was to evaluate the effectiveness of implanting interbody fusion cage containing b-TCP for the treatment of cervical radiculopathy and/or myelopathy, and the fusion rates and outcomes in patients with or without randomly assigned plate fixation. Sixty-two patients with cervical radiculopathy and/or myelopathy due to soft disc herniation or spondylosis were treated with one-or twolevel discectomy and fusion with interbody cages containing b-TCP. They were randomly assigned to receive supplemented anterior plate (n = 33) or not (n = 29). The patients were followed up for 2 years postoperatively. The radiological and clinical outcomes were assessed during a 2-year follow-up. The results showed that the fusion rate (75.0%) 3 months after surgery in patients treated without anterior cervical plating was significantly lower than that (97.9%) with plate fixation (P \ 0.05), but successful bone fusion was achieved in all patients of both groups at 6-month follow-up assessment. Patients treated without anterior plate fixation had 11 of 52 (19.2%) cage subsidence at last follow-up. No difference (P [ 0.05) was found regarding improvement in spinal curvature as well as neck and arm pain, and recovery rate of JOA score at all time intervals between the two groups. Based on the findings of this study, interbody fusion cage containing b-TCP following one-or two-level discectomy proved to be an effective treatment for cervical spondylotic radiculopathy and/or myelopathy. Supplemented anterior plate fixation can promote interbody fusion and prevent cage subsidence but do not improve the 2-year outcome when compared with those treated without anterior plate fixation.

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Section: Discussionsupporting

confidence: 82%

Section: Introductionmentioning

confidence: 99%

Anterior cervical fusion with interbody cage containing β-tricalcium phosphate augmented with plate fixation: a prospective randomized study with 2-year follow-up

Dai

Jiang

2008

Eur Spine J

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“…Agrillo et al [1] implanted 57 cages packed with coralline hydroxyapatite and reported no implant-related complications and complete fusion in all patients at 12 months. Tancredi et al [25] also reported 119 carbon fiber cages packed with autograft, allograft or hydroxyapatite.…”

Section: Radiographic Evaluationmentioning

confidence: 97%

“…Several studies have investigated the feasibility of using carbon fiber cages in the cervical spine with autograft, allograft and hydroxyapatite graft material [1,18,19,25]. Few randomized studies that compare carbon fiber cages with a standard procedure exist [22].…”

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confidence: 99%

A prospective randomized study comparing a cervical carbon fiber cage to the Smith–Robinson technique with allograft and plating: up to 24 months follow-up

2005

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IntroductionSymptomatic cervical disc herniation and degeneration are routinely treated by anterior decompression; however, the options for subsequent fusion and stabilization are numerous and ever increasing. The original anterior discectomy and fusion by Cloward [11] described interbody fusion with an autograft bone dowel. This was followed by the technique of Smith-Robinson describing the harvest of a rectangular tricortical iliac bone Abstract Introduction: Intervertebral carbon fiber cages may reduce graft collapse and promote bony fusion. Their safety and efficacy in the cervical spine have been investigated; however, no study has compared the outcomes of anterior cervical decompression and placement of a carbon fiber cage with placement of allograft and plate. Methods: Forty consecutive patients who met inclusion criteria were enrolled and randomized to anterior cervical discectomy with carbon fiber cage alone (n=20) or with allograft with plating (n=20). Clinical and radiographic evaluations were performed at baseline and at 6 weeks, 3, 6, 12 and 24 months. Neck and arm pain as well as neck disability index (NDI) were assessed at every visit. The Short Form (SF)-36 was completed prior to operation and at 12-month intervals. Cervical radiographs were evaluated pre-op and at every follow-up for evidence of fusion and instability. Results: No significant difference was found between the two randomized groups with respect to pre-operative age (mean 50 years), sex, employment status, duration of pain or cervical levels affected. The mean followup period was 14 months (range, 6-26 months). The clinical pain and disability improvements were similar for both treatments. Post-operative donor site pain was only present in the cage group, but not of significant long-term disability. At up to 24 months, NDI scores were significantly improved in both groups when compared with baseline. At 12 and 24 months, all SF-36 questionnaire responses were also improved in both the treatment groups. However, there was no statistically significant difference in outcomes between the two groups at any time. The fusion rate was 100% in both groups by 12 and 24 months, without evidence of instability. There were no differences in complications between both groups. Conclusions: The outcomes after cervical decompression and placement of a carbon fiber cage appear to be similar to cervical decompression with allograft and plating by the Smith-Robinson technique.

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“…Following the long-lasting use of autografts and allografts [2,7,8,12,15,24,36,39], intervertebral cages, without or with additional anterior cervical plates, became the most commonly used intervertebral devices [1,14,25,27,30,39].…”

Section: Introductionmentioning

confidence: 99%

Zero-P: a new zero-profile cage-plate device for single and multilevel ACDF. A single Institution series with four years maximum follow-up and review of the literature on zero-profile devices

et al. 2013

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Purpose To analyze the prospectively collected data in a series of patients treated with single-or multilevel ACDF with a stand-alone, zero-profile device, focusing on clinicoradiological outcome, complications and technical hints, and to review the literature on such new devices. Methods Eighty-five patients harboring symptomatic DDD underwent ACDF with the Zero-P cage-plate: 29 at 1-level and 56 at 2-4 levels (total 162 devices). In the multilevel group, 9 patients received a combination of Zero-P and stand-alone cages (hybrid implants). This study focuses on 32 patients with follow-up ranging from 20 to 48 months. NDI, SF-36 and arm pain VAS scores were registered preoperatively and at follow-up visits. Dysphagia was assessed using the Bazaz score. Imaging included X-rays, CT and MRI, also to assess the presence of vertebral body fractures in multilevel cases. Paired Student t test was used for statistical analysis. Results SF-36 and NDI showed a statistically significant improvement (p \ 0.01) and mean arm pain VAS score decreased from 79 to 41. X-rays and CT demonstrated, respectively, a 94.5 % and a 92 % fusion rate. Three patients complained of moderate and two of mild transient dysphagia (15.5 %). No device-related complications occurred and no fractures, secondary to four screws insertion in one vertebral body (i.e., swiss cheese effect), were detected in multilevel cases. In patients with extensive anterior osteophytes only a ''focal spondylectomy'' was required. Conclusion The Zero-P device is safe and efficient, even in multilevel cases. Dysphagia is minimal, extensive anterior osteophytectomy is unnecessary and technical hints may ease the surgical workflow. This is the largest series, with the longest follow-up, reported.

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Anterior cervical fusion with carbon fiber cage containing coralline hydroxyapatite: preliminary observations in 45 consecutive cases of soft-disc herniation

Cited by 47 publications

References 21 publications

Anterior cervical fusion with interbody cage containing β-tricalcium phosphate augmented with plate fixation: a prospective randomized study with 2-year follow-up

Anterior cervical fusion with interbody cage containing β-tricalcium phosphate augmented with plate fixation: a prospective randomized study with 2-year follow-up

A prospective randomized study comparing a cervical carbon fiber cage to the Smith–Robinson technique with allograft and plating: up to 24 months follow-up

Zero-P: a new zero-profile cage-plate device for single and multilevel ACDF. A single Institution series with four years maximum follow-up and review of the literature on zero-profile devices

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