Polyetheretherketone Interbody Cages Versus Autogenous Iliac Crest Bone Grafts With Anterior Fixation for Cervical Disc Disease

Landriel, Federico; Hem, Santiago; Goldschmidt, Ezequiel; Ajler, Pablo; Vecchi, Eduardo; Carrizo, Antonio

doi:10.1097/bsd.0b013e3182323274

Cited by 16 publications

(16 citation statements)

References 40 publications

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“…PEEK cages may achieve a significant increase in the disc space height and the neural foramina, contributing to nerve root decompression and, thereby, further controlling pain. In addition, the implantation of a PEEK cage is characterized by a significantly lower infection rate, compared to ACDF with an autologous bone graft [ 5 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2018

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BackgroundAnterior cervical discectomy and fusion (ACDF) with a polyetheretherketone (PEEK) cage is considered as the gold standard for patients with cervical disc disease. However, there are limited in vivo data on the impact of ACDF on the cervical kinematics and its association with patient-reported clinical outcomes. The purpose of this study was to investigate the impact of altered cervical sagittal alignment (cervical lordosis) and sagittal range of motion (ROM) on patients’ self-reported pain and functional disability, after ACDF with a PEEK cage.MethodsWe prospectively studied 74 patients, who underwent single-, or consecutive two-level ACDF with a PEEK interbody cage. The clinical outcomes were assessed by using the pain numeric rating scale (NRS) and the neck disability index (NDI). Radiological outcomes included cervical lordosis and C2-C7 sagittal ROM. The outcome measures were collected preoperatively, at the day of patients’ hospital discharge, and also at 6 and 12 months postoperatively.ResultsThere was a statistically significant reduction of the NRS and NDI scores postoperatively at each time point (P < 0.005). Cervical lordosis and also ROM significantly reduced until the last follow-up (P < 0.005). There was significant positive correlation between NRS and NDI preoperatively, as well as at 6 and 12 months postoperatively (P < 0.005). In regard to the ROM and the NDI scores, there was no correlation preoperatively (P = 0.199) or postoperatively (6 months, P = 0.322; 12 months, P = 0.476). Additionally, there was no preoperative (P = 0.134) or postoperative (6 months, P = 0.772; 12 months, P = 0.335) correlation between the NDI scores and cervical lordosis.ConclusionsIn our study, reduction of cervical lordosis and sagittal ROM did not appear to significantly influence on patients’ self-reported disability. Such findings further highlight the greater role of pain level over the mechanical limitations of ACDF with a PEEK cage on patients’ own perceived recovery.

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Section: Introductionmentioning

confidence: 99%

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

et al. 2018

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“…Instead, commercial interbody cages with their various shapes and designs are commonly used. These spacers provide immediate structural stability and can be filled with various bone substitutes to promote interbody fusion [ 10 , 11 ]. Anterior cervical plating can enhance the stability and fusion rate while at the same time reducing the possibility of cage subsidence, but in single-level cervical spondylotic radiculopathy (CSR) anterior plating is not usually necessary and not recommended [ 12 – 16 ].…”

Section: Introductionmentioning

confidence: 99%

Impact of Age and Duration of Symptoms on Surgical Outcome of Single-Level Microscopic Anterior Cervical Discectomy and Fusion in the Patients with Cervical Spondylotic Radiculopathy

Omidi-Kashani

Hasankhani

Ghandehari

2014

Neuroscience Journal

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We aim to evaluate the impact of age and duration of symptoms on surgical outcome of the patients with cervical spondylotic radiculopathy (CSR) who had been treated by single-level microscopic anterior cervical discectomy and fusion (ACDF). We retrospectively evaluated 68 patients (48 female and 20 male) with a mean age of 41.2 ± 4.3 (ranged from 24 to 72 years old) in our Orthopedic Department, Imam Reza Hospital. They were followed up for 31.25 ± 4.1 months (ranged from 25 to 65 months). Pain and disability were assessed by Visual Analogue Scale (VAS) and Neck Disability Index (NDI) questionnaires in preoperative and last follow-up visits. Functional outcome was eventually evaluated by Odom's criteria. Surgery could significantly improve pain and disability from preoperative 6.2 ± 1.4 and 22.2 ± 6.2 to 3.5 ± 2.0 and 8.7 ± 5.2 (1–21) at the last follow-up visit, respectively. Satisfactory outcomes were observed in 89.7%. Symptom duration of more and less than six months had no effect on surgical outcome, but the results showed a statistically significant difference in NDI improvement in favor of the patients aged more than 45 years (P = 0.032), although pain improvement was similar in the two groups.

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“…Landriel et al recently confirmed that achieving maximal endplate coverage has been shown to reduce the incidence of subsidence, thereby maintaining long-term correction of intervertebral disc space height and foraminal dimensions minimizing recurrent foraminal stenosis as well as pseudoarthrosis. 12 Anatomic restoration of cervical lordosis results in improved sagittal alignment and the possibility of reduced incidence of symptomatic adjacent segment degeneration. 9 …”

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confidence: 99%

ISASS Policy Statement - Cervical Interbody

Singh

Qureshi

2014

Int J Spine Surg

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Morgan Lorio, MD, FACS, Chair, ISASS Task Force on Coding & ReimbursementIn 2011, CPT code 22551 was revised to combine or bundle CPT codes 63075 and 22554 when both procedures were performed at the same site/same surgical session. The add on code +22552 is used to report each additional interspace. 2014 heralded a downward pressure on this now prime target code (for non-coverage?) 22551 through an egregious insurer attempt to redefine cervical arthrodesis, effectively removing spine surgeon choice and altering best practice without clinical evidence. Currently, spine surgeons are equally split on the use of allograft versus cages for cervical arthrodesis. Structural allograft, CPT code 20931, is reported once per same surgical session, regardless of the number of allografts used. CPT code 22851 which is designated solely for cage use, has a higher reimbursement than structural allograft, and may be reported for each inner space. Hence, the rationale behind why some payers wrongly consider “spine cages NOT medically necessary for cervical fusion.” A timely consensus paper summarizing spine surgeon purview on the logical progressive evolution of cervical interbody fusion for ISASS/IASP membership was strategically identified as an advocacy focus by the ISASS Task Force. ISASS appreciates the authors’ charge with gratitude. This article has both teeth and transparent clinical real-world merit.

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Polyetheretherketone Interbody Cages Versus Autogenous Iliac Crest Bone Grafts With Anterior Fixation for Cervical Disc Disease

Cited by 16 publications

References 40 publications

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

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

Impact of Age and Duration of Symptoms on Surgical Outcome of Single-Level Microscopic Anterior Cervical Discectomy and Fusion in the Patients with Cervical Spondylotic Radiculopathy

ISASS Policy Statement - Cervical Interbody

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