Techniques for cervical interbody grafting

Ryken, Timothy C.; Heary, Robert F.; Matz, Paul G.; Anderson, Paul A.; Groff, Michael W.; Holly, Langston T.; Kaiser, Michael G.; Mummaneni, Praveen V.; Choudhri, Tanvir F.; Vresilovic, Edward J.; Resnick, Daniel K.

doi:10.3171/2009.2.spine08723

Cited by 50 publications

(16 citation statements)

References 46 publications

(66 reference statements)

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“…36 Currently, it is unclear from the literature if these osteoconductive carriers result in fusions rates equivalent to autograft . [37][38][39] Recombinant bone morphogenetic proteins have been used as an additive osteoinductive agent to promote fusion. 40,41 There are, however, reports of adverse effects of their use in the cervical spine.…”

Section: Discussionmentioning

confidence: 99%

Cervical Interbody Fusion Is Enhanced by Allogeneic Mesenchymal Precursor Cells in an Ovine Model

Goldschlager

Rosenfeld

Ghosh

et al. 2011

Spine

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Section: Discussionmentioning

confidence: 99%

Cervical Interbody Fusion Is Enhanced by Allogeneic Mesenchymal Precursor Cells in an Ovine Model

Goldschlager

Rosenfeld

Ghosh

et al. 2011

Spine

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“…However, their use comes with potential problems, including risk of infections and graft rejection, higher rates of collapse and nonunion, especially in multilevel fusions, and prolonged period required for graft incorporation [46]. Ryken et al in a comprehensive review concluded that there appears to be equivalency regarding the use of harvested autogenous bone graft, allograft, polyetheretherketone, and titanium cages in anterior fusion [53]. …”

Section: Treatment Outcomes For Cervical Spondylotic Myelopathymentioning

confidence: 99%

Operative Outcomes for Cervical Myelopathy and Radiculopathy

Galbraith

Butler

Dolan

et al. 2012

Advances in Orthopedics

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Cervical spondylotic myelopathy and radiculopathy are common disorders which can lead to significant clinical morbidity. Conservative management, such as physical therapy, cervical immobilisation, or anti-inflammatory medications, is the preferred and often only required intervention. Surgical intervention is reserved for those patients who have intractable pain or progressive neurological symptoms. The goals of surgical treatment are decompression of the spinal cord and nerve roots and deformity prevention by maintaining or supplementing spinal stability and alleviating pain. Numerous surgical techniques exist to alleviate symptoms, which are achieved through anterior, posterior, or circumferential approaches. Under most circumstances, one approach will produce optimal results. It is important that the surgical plan is tailored to address each individual's unique clinical circumstance. The objective of this paper is to analyse the major surgical treatment options for cervical myelopathy and radiculopathy focusing on outcomes and complications.

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“…The iliac crest has long been recognized among many spine surgeons as a reliable source for cancellous bone. 1,8,13 However, the iliac crest is not an ideal donor site, because a variety of donorsite morbidities can result from its use. 2,7,12,[15][16][17] This has led to the search for other autologous donor sites.…”

Section: Discussionmentioning

confidence: 99%

Autologous clavicle bone graft for anterior cervical discectomy and fusion with titanium interbody cage

Iwasaki

Ikedo

Hashikata

et al. 2014

SPI

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A variety of donor-site complications have been reported for anterior cervical discectomy and fusion (ACDF) using autologous iliac bone graft. To minimize such morbidities and to obtain optimal bony fusion at the ACDF surgery, a novel technique was used to harvest cancellous bone from the autologous clavicle instead of the popular iliac crest graft. After a routine cervical discectomy of the affected level, a 1.5-cm linear skin incision was made over the clavicle within 2.5 cm of the sternoclavicular joint on the medial one-third portion. This portion is known as an anatomically safe zone, with no subcutaneous distribution of the supraclavicular nerve. Then, cancellous bone was harvested through a small cortical window developed on the clavicle. Care was taken not to injure the subclavian major vessels and the lung below the clavicle. A box-type titanium cage was packed with the harvested cancellous bone and then inserted into the discectomy-treated space for cervical interbody fusion. From 2009 to 2013, 16 patients with cervical radiculopathy and/or myelopathy underwent single-level ACDF with this method. All but 1 patient experienced significant improvement of clinical symptoms after the surgery and showed radiographic evidence of solid bony fusion and spinal stabilization within 6 months. Further, no peri- and postoperative complications at the clavicular donor site were noted. The mean visual analog scale pain score (range 0 [no pain to 10 [maximum pain]) at 1 year after the surgery was 0.1, and 13 of 14 patients with data at 1-year follow-up were highly satisfied with their donor-site cosmetic outcome. The clavicle is a safe, reliable, and technically easy source of autologous bone graft that yields optimal fusion rates and patient satisfaction with ACDF surgery.

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Techniques for cervical interbody grafting

Cited by 50 publications

References 46 publications

Cervical Interbody Fusion Is Enhanced by Allogeneic Mesenchymal Precursor Cells in an Ovine Model

Cervical Interbody Fusion Is Enhanced by Allogeneic Mesenchymal Precursor Cells in an Ovine Model

Operative Outcomes for Cervical Myelopathy and Radiculopathy

Autologous clavicle bone graft for anterior cervical discectomy and fusion with titanium interbody cage

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