Preliminary comparison of radiolucent cages containing either autogenous cancellous bone or hydroxyapatite graft in multilevel cervical fusion

Chang, Wei-Chieh; Tsou, Hsi‐Kai; Chen, Wen-Shian; Chen, Chi‐Chang; Shen, Chiung‐Chyi

doi:10.1016/j.jocn.2008.08.034

Cited by 28 publications

(32 citation statements)

References 16 publications

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“…The intervertebral cages used were made of polyetheretherketone (PEEK) (Fidji ® Cervical Cage; Abbott/Zimmer, Warsaw, IN, USA). The material used to fill the cages was autogenous cancellous bone harvested from iliac crest, or hydroxyapatite, which has been shown to result in a similar fusion rate as when cancellous bone is used as the filling material [19]. …”

Section: Methodsmentioning

confidence: 99%

Risk factors for subsidence in anterior cervical fusion with stand-alone polyetheretherketone (PEEK) cages: a review of 82 cases and 182 levels

Kao

Chou

et al. 2014

Arch Orthop Trauma Surg

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IntroductionTo determine risk factors for subsidence in patients treated with anterior cervical discectomy and fusion (ACDF) and stand-alone polyetheretherketone (PEEK) cages.Materials and methodsRecords of patients with degenerative spondylosis or traumatic disc herniation resulting in radiculopathy or myelopathy between C2 and C7 who underwent ACDF with stand-alone PEEK cages were retrospectively reviewed. Cages were filled with autogenous cancellous bone harvested from iliac crest or hydroxyapatite. Subsidence was defined as a decrease of 3 mm or more of anterior or posterior disc height from that measured on the postoperative radiograph. Eighty-two patients (32 males, 50 females; 182 treatment levels) were included in the analysis.ResultsMost patients had 1–2 treatment levels (62.2 %), and 37.8 % had 3–4 treatment levels. Treatment levels were from C2–7. Of the 82 patients, cage subsidence occurred in 31 patients, and at 39 treatment levels. Multivariable analysis showed that subsidence was more likely to occur in patients with more than two treatment levels, and more likely to occur at treatment levels C5–7 than at levels C2–5. Subsidence was not associated with postoperative alignment change but associated with more disc height change (relatively oversized cage).ConclusionSubsidence is associated with a greater number of treatment levels, treatment at C5–7 and relatively oversized cage use.

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Section: Methodsmentioning

confidence: 99%

Risk factors for subsidence in anterior cervical fusion with stand-alone polyetheretherketone (PEEK) cages: a review of 82 cases and 182 levels

Kao

Chou

et al. 2014

Arch Orthop Trauma Surg

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“…Hydroxyapatite and calcium phosphate have good biocompatibility and osteoconductive capacity, 13,22) and a mixture of calcium phosphate and hydroxyapatite has shown good clinical and radiological outcomes as an iliac bone graft alternative. 6,7,9,[14][15][16][17]21,24) PolyBone } (Kyungwon Medical Co., Ltd., Seoul, Korea) is a beta-tricalcium phosphate material designed to act as a substitute bone graft. To assess the efficacy of PolyBone for cervical interbody fusion, we retrospectively examined clinical and radiological outcomes in patients who underwent ACDF using PolyBone, and compared these with outcomes achieved in patients who underwent ACDF using iliac grafts.…”

Section: Introductionmentioning

confidence: 99%

Anterior Cervical Interbody Fusion Using Polyetheretherketone Cage Filled With Autologous and Synthetic Bone Graft Substrates for Cervical Spondylosis: Comparative Analysis Between PolyBone<sup>®</sup> and Iliac Bone

Park

Roh

2013

Neurol. Med. Chir.(Tokyo)

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Clinical and radiological outcomes of cervical interbody fusion using a polyetheretherketone cage filled with PolyBone } (Kyungwon Medical Co., Ltd., Seoul, Korea), beta-tricalcium phosphate material, and autologous iliac bone were retrospectively compared in 47 patients who underwent anterior cervical discectomy and fusion (ACDF) between January 2007 and April 2008. Of these, 23 received iliac bone grafts and 24 received PolyBone. Numeric rating scale and neck disability index were used for clinical outcome assessments. Cervical radiography was performed immediately postoperatively, and at 1, 3, 6, 12, and 24 months postoperatively. Computed tomography (CT) was performed at 12 and 24 months postoperatively. Change in segmental lordosis, disk height, and fusion were compared at 12 and 24 months postoperatively. Clinical outcomes were similar between both groups. CT and radiography at 12 months showed that fusion had occurred in 22 patients in the iliac bone group and in 19 in the PolyBone recipients. Fusion was also identified in 22 patients in both iliac bone and PolyBone groups at 24 months postoperatively. The clinical outcomes of ACDF using PolyBone and iliac bone were similar, with similar cervical interbody fusion rates at 24 months postoperatively. However, the time taken for fusion was apparently longer in the PolyBone group.

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“…Furthermore, the work by Chang et al 5 supports that anterior cervical discectomy and fusion (ACDF) is the treatment of choice for cervical disc herniation and spondylotic radiculopathy or myelopathy. In addition, Lu et al 6 have shown that anterior cervical corpectomy and fusion (ACCF) is an effective surgical procedure for the treatment of multilevel cervical myelopathy because it can remove almost all osteophytes, discs and ossification of posterior longitudinal ligament pathology that cause spinal cord compression.…”

Section: Introductionmentioning

confidence: 99%

Comparison of two anterior fusion methods in two-level cervical spondylosis myelopathy: a meta-analysis

Huang

et al. 2014

BMJ Open

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ObjectiveThe aim of this study was to evaluate the efficacy and safety of anterior cervical corpectomy and fusion (ACCF) and anterior cervical discectomy and fusion (ACDF) for treating two-adjacent-level cervical spondylosis myelopathy (CSM).DesignA meta-analysis of the two anterior fusion methods was conducted. The electronic databases of PubMed, the Cochrane Central Register of Controlled Trials, ScienceDirect, CNKI, WANFANG DATA and CQVIP were searched. Quality assessment of the included studies was evaluated using the Cochrane Risk of Bias Tool and the Methodological Index for Non-Randomised Studies criteria. Pooled risk ratios of dichotomous outcomes and standardised mean differences (SMDs) of continuous outcomes were generated. Using the χ2 and I2 tests, the statistical heterogeneity was assessed. Subgroup and sensitivity analyses were also performed.ParticipantsNine eligible trials with a total of 631 patients and a male-to-female ratio of 1.38:1 were included in this meta-analysis.Inclusion criteriaRandomised controlled trials (RCTs) and non-randomised controlled trials that adopted ACCF and ACDF to treat two-adjacent-level CSM were included.ResultsNo significant differences were identified between the two groups regarding hospital stay, the Japanese Orthopaedic Association (JOA) score, visual analogue scale (VAS) scores for neck and arm pain, total cervical range of motion (ROM), fusion ROM, fusion rate, adjacent-level ossification and complications, while ACDF had significantly less bleeding (SMD=1.14, 95% CI (0.74 to 1.53)); a shorter operation time (SMD=1.13, 95% CI (0.82 to 1.45)); greater cervical lordosis, total cervical (SMD=−2.95, 95% CI (−4.79 to −1.12)) and fused segment (SMD=−2.24, 95% CI (−3.31 to −1.17)); higher segmental height (SMD=−0.68, 95% CI (−1.03 to −0.34)) and less graft subsidence (SMD=0.40, 95% CI (0.06 to 0.75)) compared to ACCF.ConclusionsThe results suggested that ACDF has more advantages compared to ACCF. However, additional high-quality RCTs and a longer follow-up duration are needed.

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Preliminary comparison of radiolucent cages containing either autogenous cancellous bone or hydroxyapatite graft in multilevel cervical fusion

Cited by 28 publications

References 16 publications

Risk factors for subsidence in anterior cervical fusion with stand-alone polyetheretherketone (PEEK) cages: a review of 82 cases and 182 levels

Risk factors for subsidence in anterior cervical fusion with stand-alone polyetheretherketone (PEEK) cages: a review of 82 cases and 182 levels

Anterior Cervical Interbody Fusion Using Polyetheretherketone Cage Filled With Autologous and Synthetic Bone Graft Substrates for Cervical Spondylosis: Comparative Analysis Between PolyBone<sup>®</sup> and Iliac Bone

Comparison of two anterior fusion methods in two-level cervical spondylosis myelopathy: a meta-analysis

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