Clinical Outcomes between Stand-Alone Zero-Profile Spacers and Cervical Plate with Cage Fixation for Anterior Cervical Discectomy and Fusion: A Retrospective Analysis of 166 Patients
Abstract:Stand-alone (SA) zero-profile implants are an alternative to cervical plating (CP) in anterior cervical discectomy and fusion (ACDF). In this study, we investigate differences in surgical outcomes between SA and CP in ACDF. We conducted a retrospective analysis of 166 patients with myelopathy and/or radiculopathy who had ACDF with SA or CP from Jan 2013–Dec 2016. We measured surgical outcomes including Bazaz dysphagia score at 3 months, Nurick grade at last follow-up, and length of hospital stay. 166 patients … Show more
“…[77][78][79] Including a cervical plate decreases the risk of graft extrusion. 80 Ossification of the posterior longitudinal ligament is an indication of an anterior cervical corpectomy with fusion. An anterior cervical corpectomy and fusion consists of discectomies, followed by the formation of a corpectomy trough, followed by a corpectomy.…”
Section: Authors' Preferred Treatmentmentioning
confidence: 99%
“…Complications of the anterior approach include esophageal injury, vertebral artery injury, airway compromise, and a high risk of pseudarthrosis 77–79 . Including a cervical plate decreases the risk of graft extrusion 80 . Ossification of the posterior longitudinal ligament is an indication of an anterior cervical corpectomy with fusion.…”
Study Design:
Narrative review.
Objective:
To provide an overview of the evaluation and diagnosis of degenerative cervical myelopathy (DCM).
Summary of Background Data:
DCM describes several etiologies of degenerative, nontraumatic spinal cord impairment. Early diagnosis and intervention can decrease neurological decline.
Methods:
An extensive literature review was conducted.
Results:
The incidence and prevalence of DCM are increasing worldwide. Asymptomatic spinal cord compression can progress to cervical myelopathy. Static and dynamic factors contribute to spinal cord compression. Patients frequently present with decreased manual dexterity, gait instability, and neck pain. On physical exam, patients frequently present with upper motor neuron signs, a Lhermitte sign, a failed Romberg test, global proprioceptive dysfunction, and decreased pain sensation. Anatomic variation may complicate physical exam interpretation. The modified Japanese Orthopaedic Association Scale and Nurick Classification, based on functional impairment, provide diagnostic utility. Magnetic Resonance Imaging imaging is useful in narrowing the differential diagnosis, evaluating the severity of neurological impairment, and predicting disease progression.
Conclusions:
Understanding the pathophysiology of DCM and the diagnostic utility of the signs and symptoms of DCM is critical. The decision for anterior cervical discectomy and fusion (ACDF), laminoplasty, or combined ACDF and posterior cervical fusion is individualized for each patient.
“…[77][78][79] Including a cervical plate decreases the risk of graft extrusion. 80 Ossification of the posterior longitudinal ligament is an indication of an anterior cervical corpectomy with fusion. An anterior cervical corpectomy and fusion consists of discectomies, followed by the formation of a corpectomy trough, followed by a corpectomy.…”
Section: Authors' Preferred Treatmentmentioning
confidence: 99%
“…Complications of the anterior approach include esophageal injury, vertebral artery injury, airway compromise, and a high risk of pseudarthrosis 77–79 . Including a cervical plate decreases the risk of graft extrusion 80 . Ossification of the posterior longitudinal ligament is an indication of an anterior cervical corpectomy with fusion.…”
Study Design:
Narrative review.
Objective:
To provide an overview of the evaluation and diagnosis of degenerative cervical myelopathy (DCM).
Summary of Background Data:
DCM describes several etiologies of degenerative, nontraumatic spinal cord impairment. Early diagnosis and intervention can decrease neurological decline.
Methods:
An extensive literature review was conducted.
Results:
The incidence and prevalence of DCM are increasing worldwide. Asymptomatic spinal cord compression can progress to cervical myelopathy. Static and dynamic factors contribute to spinal cord compression. Patients frequently present with decreased manual dexterity, gait instability, and neck pain. On physical exam, patients frequently present with upper motor neuron signs, a Lhermitte sign, a failed Romberg test, global proprioceptive dysfunction, and decreased pain sensation. Anatomic variation may complicate physical exam interpretation. The modified Japanese Orthopaedic Association Scale and Nurick Classification, based on functional impairment, provide diagnostic utility. Magnetic Resonance Imaging imaging is useful in narrowing the differential diagnosis, evaluating the severity of neurological impairment, and predicting disease progression.
Conclusions:
Understanding the pathophysiology of DCM and the diagnostic utility of the signs and symptoms of DCM is critical. The decision for anterior cervical discectomy and fusion (ACDF), laminoplasty, or combined ACDF and posterior cervical fusion is individualized for each patient.
“…Appropriate selection of surgical intervention is based on patient characteristics, disease pathology, and risk factors. Sommaruga et al [ 11 ] compared the surgical outcomes including Bazaz dysphagia score, Nurick grade, and hospital stay between stand-alone zero-profile implants and more traditionally used cervical plating in anterior cervical discectomy and fusion. The study, consisting of 116 patients, found a shorter hospital course and operation time for stand-alone implants; however, neurologic and dysphagia outcomes were similar across both groups.…”
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