Radiological analysis of 37 segments in cervical spine implanted with a peek stand-alone device, with at least one year follow-up

Dufour, Thierry; Huppert, Jean; Louis, C; Beaurain, Jacques; Stecken, J; Aubourg, Lucie; Vila, Thierry

doi:10.3109/02688691003793029

Cited by 29 publications

(33 citation statements)

References 21 publications

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“…Initial stability could be maintained by use of a cage and the tension forces of residual annuls and ligaments. Stand-alone cages have been widely applied in 1 and 2-level pathologies [7,12,15,18]. Recently, spine surgeons started to use the stand-alone cage construct in multilevel cervical disc disease [5,8,16].…”

Section: Discussionmentioning

confidence: 99%

Comparison of titanium and polyetheretherketone (PEEK) cages in the surgical treatment of multilevel cervical spondylotic myelopathy: a prospective, randomized, control study with over 7-year follow-up

et al. 2013

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Section: Discussionmentioning

confidence: 99%

Comparison of titanium and polyetheretherketone (PEEK) cages in the surgical treatment of multilevel cervical spondylotic myelopathy: a prospective, randomized, control study with over 7-year follow-up

et al. 2013

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“…Furthermore, the necessity of adding anterior and/or posterior instrumentation in multilevel disease is still debatable [3]. Recently, stand-alone cages have been widely applied in mono-and bisegmental pathologies [8,16]. More recently, spine surgeons started to use the stand-alone cage construct in multilevel cervical disc disease [2,7,12].…”

Section: Introductionmentioning

confidence: 99%

Four-level anterior cervical discectomies and cage-augmented fusion with and without fixation

2012

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Purpose Anterior cervical decompression and fusion is a well-established procedure for the treatment of cervical spinal canal stenosis. In this study, we evaluated the necessity of spinal instrumentation after four-level anterior cervical decompression and cage fusion. Methods From January 2006 until August 2008, 25 patients (8 females and 17 males) (mean age 63.9 ± 7.9 years) suffering from spinal stenosis C3-C7 underwent anterior decompression and interbody fusion. The patients were divided into two groups. Four-level discectomy and cage fusion was performed in all patients. In group A including nine patients, posterior instrumentation with a lateral mass screw-rod system was added, while in group B including 16 patients, additional instrumentation was not performed. The mean duration of follow-up was 48.6 months (average 25-67 months). Results Clinically, the mean value for the Neck Disability Index improved from 40 ± 23.25 at presentation to 16.31 ± 15.09 at the final follow-up. The difference between the two groups was statistically not significant. Radiologically, the criteria for solid bony fusion were achieved successfully in all patients of group A, and in 87.5 % of patients in group B. The difference between the two groups was statistically not significant. The fused segment was then evaluated in the sagittal radiographs as regards the height and the lordosis angle. The loss in the height as well as the loss in the lordosis angle was more when posterior instrumentation was not added. However, the difference between the two groups was not statistically significant. Conclusion Stand-alone intersomatic cage fusion is an acceptable line of treatment for four-level cervical disc disease, both clinically and radiologically. Although the addition of posterior instrumentation yields better radiological results, the difference does not reach the statistical significance level.

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“…Preoperative radicular weakness was present in 18 patients (36%) and the mean medical research council (MRC) strength score preoperatively was 4.5/5±0.88. The mean duration of symptoms (in general) preoperatively was 3.69 months (range [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20].…”

Section: Resultsmentioning

confidence: 99%

“…15,[18][19][20]22 Polyetheretherketone (PEEK) is a popular material used for cervical cages, as its elastic modulus is similar to bone. 5,17 One of the concerns related to insertion of stand-alone cage in ACDF is cage subsidence which could reduce disc height and lordosis and subsequently result in reduced foraminal height and foraminal narrowing which in turn could lead to worse neck pain and/or recurrent radiculopathy. 9 Published literature contains mixed results in terms of rate of cage subsidence and loss of lordosis in ACDF with a stand-alone PEEK cage.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Subsidence in Stand-Alone Cervical Cage: Incidence, Risk Factors and Effects on Clinical and Radiological Picture

Hamada¹,

AbouZeid²

2015

Egyptian Spine Journal

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Background Data: Anterior Cervical Discectomy and Fusion is the gold standard for treating cervical degenerative disc disease associated with radiculopathy and/or myelopathy. When indicated, surgery can achieve neural tissue decompression and biomechanical stabilization through bony fusion. One of the known complications of stand-alone anterior cervical cage is cage subsidence. Published literature however, contains mixed results in terms of rate of cage subsidence, loss of lordosis and its clinical effects. Purpose: We report our experience in stand-alone anterior cervical cage, our subsidence rate and its effect on loss of lordosis and clinical picture Study Design: Retrospective clinical case study. Patients and Methods: we inserted seventy-two cervical cages (in fifty patients), who had Anterior Cervical Discectomy and Fusion using a stand-alone polyetheretherketone (PEEK) cage under our care. We recorded the self-reported Visual Analogue Score for arm and neck pain and measured the total intervertebral height/disc space or cage ratio, segmental Cobb angle, the distance between the anterior rim of the cage and the anterior vertebral body line, superior or inferior end plate violation and anterior or posterior cage migration on lateral X ray film preoperatively and on each follow up visit (day 1, 7-21 days, 3, and 6 months). Results: Our cage subsidence rate in the studied sample was 23.6% in 6 months (17 out of 62 cages subsided). We found a statistically significant correlation between immediate postoperative disc height and subsidence (the more distraction we applied to the disc space the more likely subsidence would happen). Cage subsidence did not increase the incidence of recurrence of radicular, myelopathic symptoms or neck pain although it resulted in significant loss of the segmental Cobb angle. Conclusions: Disc space over-distraction in stand-alone anterior cervical cage significantly increases the risk of subsidence. Subsidence significantly affects the segmental Cobb angle but not the clinical outcome. (2015ESJ077)

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Radiological analysis of 37 segments in cervical spine implanted with a peek stand-alone device, with at least one year follow-up

Cited by 29 publications

References 21 publications

Comparison of titanium and polyetheretherketone (PEEK) cages in the surgical treatment of multilevel cervical spondylotic myelopathy: a prospective, randomized, control study with over 7-year follow-up

Comparison of titanium and polyetheretherketone (PEEK) cages in the surgical treatment of multilevel cervical spondylotic myelopathy: a prospective, randomized, control study with over 7-year follow-up

Four-level anterior cervical discectomies and cage-augmented fusion with and without fixation

Evaluation of Subsidence in Stand-Alone Cervical Cage: Incidence, Risk Factors and Effects on Clinical and Radiological Picture

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