Long term outcome of anterior cervical discectomy and fusion using coral grafts

Ramzi, Najib; Vaz, José Géraldo Ribeiro; Fomekong, Edward; Lecouvet, Frédéric; Raftopoulos, Christian

doi:10.1007/s00701-008-0140-1

Cited by 13 publications

(13 citation statements)

References 28 publications

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“…Twenty-five studies [20,23–25,33,35,36,40,47,51,59,61,62,68,69,73–76,78,85,86,91,117,118] containing 142 patients with infection of 3489 patients after cervical surgery were included. Figure 21 shows that the incidence was 2.8% (95% CI 1.7%–4.0%), with substantial heterogeneity of incidence observed.…”

Section: Resultsmentioning

confidence: 99%

Prevalence of complications after surgery in treatment for cervical compressive myelopathy

et al. 2017

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Purpose:We aim to perform a meta-analysis on prevalence of all kinds of operation-related complications following surgery treating cervical compressive myelopathy (CCM) and to provide reference for surgeons making surgical plan.Methods:An extensive search of literature was performed in PubMed/MEDLINE, Embase, the Cochrane library, CNKI, and WANFANG databases on incidence of operation-related complications from January 2007 to November 2016. Data was calculated and data analysis was conducted with STATA 12.0 and Revman 5.3.Results:A total of 107 studies included 1705 of 8612 patients (20.1%, 95% CI 17.3%–22.8%) on overall complications. The incidence of C5 plasy, cerebrospinal fluid (CSF), infection, axial pain, dysphagia, hoarseness, fusion failure, graft subsidence, graft dislodgment, and epidural hematoma is 5.3% (95% CI 4.3%–6.2%), 1.9% (95% CI 1.3%–2.4%), 2.8% (95% CI 1.7%–4.0%), 15.6% (95% CI 11.7%–19.5%), 16.8% (95% CI 13.6%–19.9%), 4.0% (95% CI 2.3%–5.7%), 2.6% (95% CI 0.2%–4.9%), 3.7% (95% CI 2.0%–5.5%), 3.4% (95% CI 2.0%–4.8%), 1.1% (95% CI 0.7%–1.5%), respectively. Patients with ossification of posterior longitudinal ligament (OPLL) (6.3%) had a higher prevalence of C5 plasy than those with cervical spondylotic myelopathy (CSM) (4.1%), and a similar trend in CSF (12.2% vs 0.9%). Individuals after laminectomy and fusion (LF) had highest rate of C5 plasy (15.2%), while those who underwent anterior cervical discectomy and fusion (ACDF) had the lowest prevalence (2.0%). Compared with patients after other surgical options, individuals after anterior cervical corpectomy and fusion (ACCF) have the highest rate of CSF (4.2%), infection (14.2%), and epidural hematoma (3.1%). Patients after ACDF (4.8%) had a higher prevalence of hoarseness than those with ACCF (3.0%), and a similar trend for dysphagia between anterior corpectomy combined with discectomy (ACCDF) and ACCF (16.8% vs 9.9%).Conclusions:Based on our meta-analysis, patients with OPLL have a higher incidence of C5 palsy and CSF. Patients after LF have a higher incidence of C5 palsy, ACCDF have a higher incidence of dysphagia, ACCF have a higher incidence of CSF and infection and ACDF have a higher incidence of hoarseness. These figures may be useful in the estimation of the probability of complications following cervical surgery.

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Section: Resultsmentioning

confidence: 99%

Prevalence of complications after surgery in treatment for cervical compressive myelopathy

et al. 2017

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“…In 38 of the 146 articles, it was mentioned whether the radiographs were analysed by a radiologist or a clinician. In 26 of these, analysis was performed by a radiologist [10,13,20,24,32,49,50,54,57,58,64,74,85,94,[97][98][99][100][101][102][103][104][105][106][107][108]. They found fusion was achieved in 93.5% of patients after a median follow-up of 23 months.…”

Section: Methods Of Measuring Bony Fusionmentioning

confidence: 99%

Evaluation of bony fusion after anterior cervical discectomy: a systematic literature review

2018

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Purpose Anterior cervical discectomy and fusion (ACDF) has proven effective in treating radicular arm pain. Post-operatively, cervical spine stability is temporarily challenged, but data on bony fusion and speed of fusion are ambiguous; optimum evaluation method and criteria are debated. Aim To study bony fusion accomplishment and to obtain an overview of methods to evaluate fusion. Methods A literature search was performed in PubMed and Embase. Included studies had to report original data concerning 1-or 2-level ACDF with intervertebral device or bone graft, where bony fusion was assessed using CT scans or X-rays. Results A total of 146 articles comprising 10,208 patients were included. Bony fusion was generally defined as "the presence of trabecular bridging" and/or "the absence of motion". Fusion was accomplished in 90.1% of patients at the final follow-up. No gold standard for assessment could be derived from the results. Addition of plates and/or cages with screws resulted in slightly higher accomplishment of fusion, but differences were not clinically relevant. Eighteen studies correlated clinical outcome with bony fusion, and 3 found a significant correlation between accomplishment and better clinical outcome. Conclusions In approximately 90% of patients, bony fusion is accomplished one year after ACDF. As there is no generally accepted definition of bony fusion, different measuring techniques cannot be compared to a gold standard and it is impossible to determine the most accurate method. Variations in study design hamper conclusions on optimising the rate of bony fusion by choice of material and/or additives. Insufficient attention is paid to correlation between bony fusion and clinical outcome.Graphical abstract These slides can be retrieved from electronic supplementary material.

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“…67 Clinical studies utilizing Biocoral ® have shown mixed results. [74][75][76][77][78][79][80][81][82][83] Early studies have utilized Biocoral ® in the treatment of bony maxillofacial defects. Of interest is the study of Roux et al presented the outcome of this product in 183 patients.…”

Section: Animal Studiesmentioning

confidence: 99%

“…75 In cervical fusion a poor fusion rate of 45 % and 60% has been reported in two studies of 48 and 40 patients. 76,77 In scaphoid fractures, the utilization of a composite graft composed of Biocoral ® , BMP and collagen resulted in a high failure rate of 80%. 78 The use of the same implant however, in 4 diaphyseal and one olecranon ulnar non-union resulted in successful consolidation in all cases.…”

Section: Animal Studiesmentioning

confidence: 99%

Is there a role of coral bone substitutes in bone repair?

Pountos

Giannoudis

2016

Injury

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Xenogeneic bone graft materials are an alternative to autologous bone grafting. Among such implants, coralline-derived bone grafts substitutes have a long track record as safe, biocompatible and osteoconductive graft materials. In this review, we present the available literature surrounding their use with special focus on the commercially available graft materials. Corals thanks to their chemical and structural characteristics similar to those of the human cancellous bone have shown great potential but clinical data presented to date is ambiguous with both positive and negative outcomes reported.Correct formulation and design of the graft to ensure adequate osteo-activity and resorption appears intrinsic to a successful outcome.

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Long term outcome of anterior cervical discectomy and fusion using coral grafts

Abstract: Despite satisfactory clinical results and a long follow-up period, coral implants yield low fusion rates, particularly in patients with discal hernia of two-level arthrodesis. The use of coral grafts cannot be recommended when fusion is one of the post-operative endpoints.

Cited by 13 publications

References 28 publications

Prevalence of complications after surgery in treatment for cervical compressive myelopathy

Prevalence of complications after surgery in treatment for cervical compressive myelopathy

Evaluation of bony fusion after anterior cervical discectomy: a systematic literature review

Is there a role of coral bone substitutes in bone repair?

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