Empty bladed peek cage for interbody fusion after acd

Abstract

ABSTRACTassociated with uncontrolled fusion and cervical kyphosis, particularly in cases with 2 and 3 level CDH (30).On the other hand, the addition of a disc prosthesis after ACD has some theoretical advantages, including motion preservation, and reduced rate of adjacent segment disease. However, adjacent segment problem, heterotopic ossification and high cost related problems remain (45, 50).another technique, anterior cervical foraminotomy, is an effective technique, particularly for foraminal herniations. There is, however, a risk of injury to the vertebral artery and █ InTRODuCTIOnCervical disc herniation (CDH) is an important disorder affecting health care. Many surgical treatment modalities have been used to treat CDH, including anterior cervical discectomy (ACD) (30, 39,41), anterior cervical discectomy and fusion (ACDF) (1, 3, 6, 8-10, 16, 25-27, 29, 31, 35, 36, 38, 43, 46, 47), anterior foraminotomy (32, 42), keyhole foraminotomy (12, 18,40, 49), and arthroplasty (5, 19,36,41). Each approach has its advantages and disadvantages. ACD has been used for many years and has encouraging results in one level cases with a stable cervical spine. However, long term results of ACD are AIM: Cervical disc herniation (CDH) can be treated using different anterior and posterior methods. Anterior cervical discectomy and fusion (ACDF) is currently gold standard and provides bony fusion and good clinical outcome. Recently many studies reported good clinical and radiological outcomes in cases who underwent anterior cervical discectomy (ACD) and reconstruction with empty cage. This study aimed to review our results after cervical microdiscectomy reconstructed with empty polyether ether ketone (pEEk) cage. MATERIAl and METhODS:Twenty-five cases with single level CDH who underwent microdiscectomy were included to this study. Reconstruction was performed using empty bladed cervical PEEK cages. Clinical (Visual analogue scale (VAS) and Odom scores) and radiological results (intervertebral disc and foraminal heights, mean cervical spine lordosis angle, and fusion rate) were reviewed one day and one year after surgery.RESulTS: There were 18 males and 7 females, aged between 25 and 54 years (mean: 40.8). Mean neck and arm VAS scores reduced from 2.9 to 1.4, and from 7.2 to 1.8, respectively. Odom scores were found to be 1.6 and 1.4 at 1 st day and one year postoperatively, respectively. Subsidence was seen in three cases (12%). There was no significant change in heights of neural foramina and intervertebral discs, and no change in cervical spine lordosis, when compared postoperative 1 st day and one year radiographs. Fusion was detected in 92% of cases in one year.COnCluSIOn: Bladed cervical cages are safe with almost no risk of dislocation. Empty cages provide acceptable rates of fusion and subsidence.

Correlation of Clinical and Radiological Outcome After Anterior Cervical Discectomy and Fusion With a Polyetheretherketone Cage

“…Therefore, the achieved mechanical decompression of the compressed cervical roots and the possible restoration of the local micro-circulation may result in pain reduction [ 13 ]. Consistent with other clinical series [ 4 , 10 , 11 , 14 - 16 ], our current data clearly indicated that there was a statistically significant reduction of neck/arm pain among our patients at their discharge from the hospital. This effect was maintained during their 12-month follow-up period.…”

“…The essential purpose of ACDF with a PEEK cage is to decompress the spinal cord and other neural structures whilst to maintain the stability of the cervical spine. Additionally, there is strong body of evidence that PEEK cage implantation restores and successfully maintains the intervertebral disc height and also the neural foramina height, postoperatively [ 4 , 10 - 12 ]. Therefore, the achieved mechanical decompression of the compressed cervical roots and the possible restoration of the local micro-circulation may result in pain reduction [ 13 ].…”

“…The reported results for ACDFs are excellent for the patients, as this is generally stated in the pertinent literature [ 1 , 2 ]. ACDF in the vast majority of cases successfully reduces neck and arm pain, restores both vertebral disc height and foraminal height, and also leads to an osseous fusion [ 3 , 4 ].…”

The outcomes of stand alone polyetheretherketone cages in anterior cervical discectomy and fusion

“…Cho et al [14] utilized radiographs to assess fusion without any further details on how fusion was objectively measured. Three studies determined fusion through evaluating motion on lateral cervical radiographs and bone bridging on computed tomography (CT) scan [20,23,30]. Zhou et al [15], Liao et al [16], and Klingler et al [19] evaluated fusion by using CT scans only.…”

“…Zhou et al [15], Liao et al [16], and Klingler et al [19] evaluated fusion by using CT scans only. The subsidence rate was evaluated vaguely by radiographs in three studies [14,16,23]. Three studies defined subsidence as the radiographic change of at least 3 mm in the interbody space [13,17,24,25], whereas another two studies considered subsidence as a change of at least 2 mm in the interbody distance [21,22].…”