Functional Outcomes of Subaxial Spine Injuries Managed With 2-Level Anterior Cervical Corpectomy and Fusion: A Prospective Study

Jain, Vaibhav; Madan, Ankit; Thakur, Manoj Kumar; Thakur, Amit

doi:10.14245/ns.1836100.050

Cited by 11 publications

(6 citation statements)

References 17 publications

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“…Approximately 90% of subjects with radiculopathy preoperatively were recovered and were asymptomatic at follow-up. Han et al evaluated 27.6 months of follow-up, in which 21 cases (21.4%) showed an improvement in the Frankel grade with complete fusion in all cases [20][21] . In Anissipour et al analysis who shared data on 36 patients with dislocation of facet treated with ACDF by fixed plate and for 324 days were followed-up.…”

Section: Discussionmentioning

confidence: 99%

Surgical Results of Sub-Axial Cervical Injury in Adult Patients Treated Via Anterior Approach

Faizullah¹,

Ali²,

Saima³

et al. 2022

PJMHS

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Objectives: To determine the results of treatment of sub-axial cervical injury in adults using open reduction, anterior approach and injury stabilization <72 hours. Place and Duration: In the Neurosurgery department of Pakistan Institute of Medical Sciences, Islamabad for one-year duration from January 2021 to December 2021. Methods: 82 total patients diagnosed with history of traumatic sub-axial injury using MRI and anteroposterior and x-rays lateral and anteroposterior views were selected. ASIA Impairment Scale was applied for valuation, which was completed at admission and 6-months later. Results: The patients mean age in this analysis was 39.20± 5.11 years. Conferring to the ASIA scale, 2 grades enhancement were realised in 24 cases and 54 cases have one grade improvement. Death occurred in 4 cases, 2 were linked to accompanying trauma, one was associated with the complication of the surgery, and the remaining 1 death were related to complications like aspiration. The results were good in 58 (74.5%) of 78 cases and satisfactory in 20 (25.5%). Conclusions: Anterior Cervical Discectomy and Fusion (ACDF) in this study showed good results and considered reliable option of treatment for improved stabilization of the spine anatomically with primary reduction. Keywords: Anterior approach, sub-axial cervical injury and ASIA (American Spinal Injury Association) scoring.

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Section: Discussionmentioning

confidence: 99%

Surgical Results of Sub-Axial Cervical Injury in Adult Patients Treated Via Anterior Approach

Faizullah¹,

Ali²,

Saima³

et al. 2022

PJMHS

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“…An anterior approach with ACCF is widely considered a safe and effective surgical treatment to achieve spinal cord decompression and high fusion rates in degenerative pathologies as well as traumatic spinal injuries. 1 , 2 , 15 , 21 However, whether ACCF provides sufficient stability on its own, especially in multilevel ACCFs, remains controversial. Additional surgery with PF can provide extra support to improve cervical stability and is sometimes performed at the index operation or later as supplementary surgery due to material failure or instability.…”

Section: Discussionmentioning

confidence: 99%

“…A study of 300 ACCF surgeries showed 2-level ACCFs being more susceptible to severe subsidence and related complications compared to single-level ACCFs. 26 A more recent study showed no stability-related complications when analyzing the outcome of 23 patients treated with 2-level ACCF for subaxial injuries, 2 but the presented radiographic follow-up data were limited. A study of 21 patients with CSM treated with ACCF showed instability in 33% of the cases and recommended a combination with PF for ≥2-level surgeries.…”

Section: Discussionmentioning

confidence: 99%

“…ACCF may be the treatment of choice for several cervical conditions. 1 , 2 , 8 , 13 , 14 , 17 While ACCF effectively decompresses the spinal cord, it is debated whether it can provide enough cervical stability, especially in multilevel ACCFs, or whether an additional posterior fixation (PF) is required. 2 , 3 , 12 , 14 , 18-20 Different pathologies may require different considerations when ACCF is performed.…”

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confidence: 99%

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Anterior Cervical Corpectomy and Fusion for Degenerative and Traumatic Spine Disorders, Single-Center Experience of a Case Series of 119 Patients

et al. 2020

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BACKGROUND Anterior cervical corpectomy and fusion (ACCF) is a treatment option for several cervical pathologies. Various graft materials such as autografts, titanium mesh cages (TMC), or poly-ether-ether-ketone (PEEK) cages are used. Additional posterior fixation (PF) to provide extra support and improve stability is sometimes performed initially, or later as supplementary treatment. OBJECTIVE To describe our retrospective study of 119 consecutive cases of ACCF with synthetic grafts, in 3 cohorts of cervical spondylotic myelopathy (CSM), infectious and neoplastic processes, and trauma, with special focus on need for supplementary PF. METHODS A total of 135 adult patients treated with ACCF between January 2005 and January 2018 were identified. Patients lost to follow-up were excluded, and 119 remaining patients were included for retrospective clinical and radiological assessment. RESULTS Synthetic grafts were used in 116 (97%) cases. Only 9 (8%) ACCF cases required later supplementary PF, where 7 (78%) cases were multilevel. There was a statistically significant difference in revision rate with PF for single-level compared to multilevel ACCFs (P = .001). Revision rates with PF were 2%, 29%, and 7% in CSM, infectious and neoplastic processes, and trauma cohorts, respectively. CONCLUSION The results indicate that ACCF is a safe and effective treatment for degenerative and traumatic cervical spine disorders, with low complication and revision rates. Single-level ACCF can be performed without additional PF. Multilevel ACCF (n > 2) and pathologies affecting bone quality seem to be risk factors for material subsidence and instability. In these cases, additional PF should be considered.

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“…No COVID-19 patients were treated. The neurological status was assessed using the American Spinal Injury Association (ASIA) impairment scale as it can be used for traumatic [5] as well as non-traumatic SCI [6]. Thoracolumbar injury classification and severity score (TLICS) based on the morphology of the injury, the integrity of the posterior ligamentous complex, and neurological status of the patient was performed in which points are assigned for each category and the final total points suggest the possible treatment option for thoracolumbar vertebral fractures [7].…”

Section: Methodsmentioning

confidence: 99%

Adapting Policy Guidelines for Spine Surgeries During COVID-19 Pandemic in View of Evolving Evidences: An Early Experience From a Tertiary Care Teaching Hospital

Verma¹,

Nagar²,

Jain³

et al. 2020

Cureus

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Eight patients (61.5%) presented with spinal cord injury (SCI) due to vertebral fracture with fall from height (87.5%) as the most common etiology. Among the traumatic SCI patients, six (75%) were managed surgically with posterior decompression and instrumented fusion with pedicle screws while two patients (25%) were managed conservatively. There were four patients (30.8%) of tuberculosis of the spine of whom two (50%) were managed with posterior decompression, debridement, and stabilization with pedicle screws, samples for culture, biopsy, and cartridge-based nucleic acid amplification test (CBNAAT) were collected during the procedure; for the remaining two patients (50%), a trans-pedicular biopsy was performed to confirm the diagnosis for initiation of anti-tubercular therapy. Prolapsed intervertebral disc causing cauda equina syndrome was the reason for emergency surgery in one patient (7.7%). COVID-19 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) reverse transcription-polymerase chain reaction (RT-PCR) test was performed in four patients (30.8%), in whom the most common symptom was fever (two patients (50%)). These patients were residents of high prevalence area for COVID-19 infection. Sore throat (25%), fatigue (25%), and low oxygen saturation (25%) were present in one patient which prompted us to get the COVID-19 test. All patients were reported negative for COVID-19. Conclusion The structural organization and the management protocol we describe allowed us to reduce infection risk and ultimately hospital stay, thereby maximizing the already stretched available medical resources. These precautions helped us to reduce transmission and exposure to COVID-19 in health care workers (HCW) and patients in our institute. The aim of this article is that our early experience can be of value to the medical communities that will soon be in a similar situation.

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Functional Outcomes of Subaxial Spine Injuries Managed With 2-Level Anterior Cervical Corpectomy and Fusion: A Prospective Study

Cited by 11 publications

References 17 publications

Surgical Results of Sub-Axial Cervical Injury in Adult Patients Treated Via Anterior Approach

Surgical Results of Sub-Axial Cervical Injury in Adult Patients Treated Via Anterior Approach

Anterior Cervical Corpectomy and Fusion for Degenerative and Traumatic Spine Disorders, Single-Center Experience of a Case Series of 119 Patients

Adapting Policy Guidelines for Spine Surgeries During COVID-19 Pandemic in View of Evolving Evidences: An Early Experience From a Tertiary Care Teaching Hospital

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