Single or double-level anterior interbody fusion techniques for cervical degenerative disc disease

Jacobs, Wilco C. H.; Willems, Paul; Limbeek, Jacques van; Bartels, Ronald H. M. A.; Pavlov, Paul W.; Anderson, Peter; Öner, F. Cumhur

doi:10.1002/14651858.cd004958.pub2

Cited by 71 publications

(38 citation statements)

References 81 publications

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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%

“…21 Surgery is usually indicated after failure of conservative measures and it aims at neural tissue decompression in addition to achieving biomechanical stability after bony fusion takes place. 4,8,14 Although some surgeons perform anterior cervical discectomy without fusion, it has been associated with the risk of reduced disc height and focal loss of lordosis in addition to foraminal stenosis, which may result in neck pain and recurrence of radiculopathy. 2,7 As a result of this, fusion is increasingly utilised following anterior cervical discectomy.…”

Section: Introductionmentioning

confidence: 99%

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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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Section: Resultsmentioning

confidence: 99%

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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“…These authors also found moderate evidence that autograft alone provides better fusion than the addition of a cage for 1-or 2-level surgery. 19 The systematic reviews by van Limbeek and colleagues 40 and Wigfield and Nelson 42 did not find a gold standard, nor did they find a technique superior to the use of autograft.…”

Section: Anterior Cervical Arthrodesismentioning

confidence: 99%

“…Four systematic reviews were identified. 12,19,40,42 The remainder of the studies selected for inclusion were randomized trials, prospective cohort studies, or large case series reports.…”

Section: Search Criteriamentioning

confidence: 99%

“…This review appropriately included randomized controlled trials, but also allowed inclusion of cohort studies and 1 large case series. 12 Jacobs and colleagues' systematic review 19 in the Cochrane Database found 4 studies with 218 patients comparing autograft with different techniques. In general, the methodological quality of the underlying studies was low.…”

Section: Anterior Cervical Arthrodesismentioning

confidence: 99%

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Techniques for cervical interbody grafting

Ryken

Heary²,

Matz

et al. 2009

SPI

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Object The objective of this systematic review was to use evidence-based medicine to determine the efficacy of interbody graft techniques. Methods The National Library of Medicine and Cochrane Database were queried using MeSH headings and keywords relevant to cervical interbody grafting. Abstracts were reviewed and studies that met the inclusion criteria were selected. The guidelines group assembled an evidentiary table summarizing the quality of evidence (Classes I–III). Disagreements regarding the level of evidence were resolved through an expert consensus conference. The group formulated recommendations that contained the degree of strength based on the Scottish Intercollegiate Guidelines network. Validation was done through peer review by the Joint Guidelines Committee of the American Association of Neurological Surgerons/Congress of Neurological Surgeons. Results Autograft bone harvested from the iliac crest, allograft bone from either cadaveric iliac crest or fibula, or titanium cages and rectangular fusion devices, with or without the use of autologous graft or substitute, have been successful in creating arthrodesis after 1- or 2-level anterior cervical discectomy with fusion (Class II). Alternatives to autograft, allograft, or titanium cages include polyetheretherketone cages and carbon fiber cages (Class III). Polyetheretherketone cages have been used successfully with or without hydroxyapatite for anterior cervical discectomy with fusion. Importantly, recombinant human bone morphogenic protein-2 carries a complication rate of up to 23–27% (especially local edema) compared with 3% for a standard approach. Conclusions Current evidence does not support the routine use of interbody grafting for cervical arthrodesis. Multiple strategies for interbody grafting have been successful with Class II evidence supporting the use of autograft, allograft, and titanium cages.