scholarly journals Analysis of the Variables Affecting the Incidence, Location, and Severity of Cage Subsidence Following Anterior Cervical Discectomy and Fusion Operation

10.14444/7137 ◽  
2020 ◽  
pp. 7137
Author(s):  
Andrew P. MacCormick ◽  
Himanshu Sharma
Keyword(s):  
Anterior Cervical Discectomy ◽  
Cervical Discectomy ◽  
Cage Subsidence ◽  
Fusion Operation

Outcomes of contemporary use of rectangular titanium stand-alone cages in anterior cervical discectomy and fusion: Cage subsidence and cervical alignment

2012 ◽  
Vol 19 (12) ◽  
pp. 1673-1678 ◽  
Author(s):  
Toru Yamagata ◽  
Toshihiro Takami ◽  
Takehiro Uda ◽  
Hidetoshi Ikeda ◽  
Takashi Nagata ◽  
...  
Keyword(s):  
Anterior Cervical Discectomy ◽  
Cervical Discectomy ◽  
Cervical Alignment ◽  
Cage Subsidence ◽  
Fusion Cage

scholarly journals Factors Influencing Interbody Cage Subsidence Following Anterior Cervical Discectomy and Fusion

2019 ◽  
Vol 32 (7) ◽  
pp. 297-302 ◽  
Author(s):  
Hidetoshi Igarashi ◽  
Masahiro Hoshino ◽  
Keita Omori ◽  
Hiromi Matsuzaki ◽  
Yasuhiro Nemoto ◽  
...  
Keyword(s):  
Anterior Cervical Discectomy ◽  
Interbody Cage ◽  
Cervical Discectomy ◽  
Factors Influencing ◽  
Cage Subsidence

scholarly journals Long-Term Results of Multiple Anterior Cervical Discectomy with Cage Fusion Technique: Results of Multiple Centre Study

2019 ◽  
Vol 7 (17) ◽  
pp. 2824-2828 ◽  
Author(s):  
Hamdi Mostafa ◽  
Mohsen Lotfi ◽  
M. Wahid
Keyword(s):  
Neck Pain ◽  
Anterior Cervical Discectomy ◽  
Long Term Results ◽  
Cervical Disc ◽  
Fusion Technique ◽  
Cervical Discectomy ◽  
Cage Subsidence ◽  
Long Term Follow Up

BACKGROUND: Cervical herniation is commonly treated by anterior cervical discectomy and fusion (ACDF) if conservative management has failed in relief of the patient's symptoms. Disc fusion is needed after ACDF as anterior longitudinal ligament will be absent after doing the operation, especially if multiple levels are needed. The occurrence of complications as cage subsidence and adjacent segment failure related to the length of follow up as they are increasing in percentage is directly proportional to the length of follow up. AIM: Analysis of the results for patients who underwent 3 levels of ACDF with cage fusion for short term and long term follow up in multiple centres as the visual analogue score for neck pain & brachialgia. METHODS: This retrospective cohort series of 68 patients selected out of 136 patients suffering from 3 levels of degenerative cervical disc disease who were unresponsive to adequate conservative therapy. All cases were treated at one of the neurosurgery departments of 3 different hospitals (Naser institute for research and treatment hospital, Haram hospital for research and treatment and Misr university for science and technology) by the same surgical team in the period from February 2012 to February 2017. RESULTS: We found in this study;68 patients fulfilling the inclusion criteria, of the 29 patients underwent 3 levels of ACDF starting from C3-4 (42.65%) and 39 patients who underwent 3 levels of ACDF starting from C4-5 (57.35%). Clinical assessment for VAS pain score for both neck pain and radiculopathy were done before the surgery and immediately post-operative and during each time follow up visit and we found statistically significant immediate postoperative improvement. (P ˂ 0.05) CONCLUSION: Stand-alone three levels of an anterior cervical discectomy with cage fusion technique improved the clinical outcomes on long term follow up.

scholarly journals Biomechanical Effect of Plate-to-Disc Distance on Surgical and Adjacent Segment in C5/C6 Anterior Cervical Discectomy and Fusion - A Finite Element Analysis

2020 ◽  
Author(s):  
Yuan Xue ◽  
Xing Guo ◽  
Jiaming Zhou ◽  
Yueyang Tian ◽  
Liang Kang
Keyword(s):  
Finite Element ◽  
Intervertebral Disc ◽  
Bone Graft ◽  
Anterior Cervical Discectomy ◽  
Von Mises Stress ◽  
Adjacent Segment ◽  
Titanium Plate ◽  
Cervical Discectomy ◽  
Cage Subsidence ◽  
Biomechanical Effect

Abstract Background: The PDD is an important factor affecting the degeneration of adjacent segments after ACDF. However, the most suitable PDD is controversial. This study examined the adjacent intervertebral disc stress, bone graft stress, titanium plate stress and screw stress to evaluate the biomechanical effect of different Plate-to-Disc Distance (PDD) on surgical segment and adjacent segment following C5/C6 anterior cervical discectomy and fusion (ACDF). Methods: We constructed 10 preoperative finite element models (FEM) of intact C4–C7 segments and validated them in the present study. We simulated ACDF surgery based on the 10 intact models in software. We designed three different distance of Plate-to-Disc titanium plates: L, long PDD (10 mm); S, short PDD (0 mm); and N, PDD (5 mm). The changes in C4/C5 and C6/C7 intervertebral disc stress, bone graft stress, titanium plate stress and screw stress were analyzed.Results: The von Mises stress of C4/C5 and C6/C7 intervertebral discs have no significant differences (P>0.05) in three different PDD groups. Titanium plate stress increased as the PDD decreased. The bone graft stress and screws stress decreased as the PDD decreased. The maximum stress of each part occurred was mostly in the conditions of rotation and lateral bending. Conclusions: The PDD has no effect on adjacent intervertebral disc stress, but it is an important factor that affecting the bone graft stress, titanium plate stress and screws stress after ACDF. Shorter PDD plate can provide better stability to reduce stress on screws and bone graft, that may be helpful to prevent cage subsidence, pseudarthrosis and instrument failure. This can serve as a reference for clinical choice of plate.

scholarly journals Safety and Efficiency of Biomimetic Nanohydroxyapatite/Polyamide 66 Composite in Rabbits and Primary Use in Anterior Cervical Discectomy and Fusion

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Hui Xu ◽  
Yan Wang ◽  
Xiaojing Su ◽  
Xuelian Zhang ◽  
Xuesong Zhang
Keyword(s):  
Cervical Spondylosis ◽  
Sagittal Alignment ◽  
Hind Femur ◽  
Anterior Cervical Discectomy ◽  
Peek Cage ◽  
Polyamide 66 ◽  
Cervical Discectomy ◽  
Cage Subsidence ◽  
Cervical Spondylosis Myelopathy

This study was conducted to validate the safety and efficiency of biomimetic nanohydroxyapatite/polyamide 66 (n-HA/PA66) composite in animal model (rabbit) and report its application in anterior cervical discectomy and fusion (ACDF) for 4, 12, and 24 weeks. N-HA/PA66 composite was implanted into one-side hind femur defects and the control defects were kept empty as blank controls. A combination of macroscopic and histomorphometric studies was performed up to 24 weeks postoperatively and compared with normal healing. 60 cervical spondylosis myelopathy and radiculopathy patients who were subjected to ACDF using n-HA/PA66 and PEEK cage were involved in this study with six-month minimum follow-up. Their radiographic (cage subsidence, fusion status, and segmental sagittal alignment (SSA)) and clinical (VAS and JOA scales) data before surgery and at each follow-up were recorded and compared. Nanohydroxyapatite/polyamide 66 composite is safe and effective in animal experiment and ACDF.

scholarly journals Preliminary outcomes of allograft and hydroxyapatite as substitutes for autograft in anterior cervical discectomy and fusion with self-locking standalone cages

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Changsheng Yang ◽  
Wentao Zhuo ◽  
Qingchu Li ◽  
Caiqiang Huang ◽  
Huibo Yan ◽  
...  
Keyword(s):  
Clinical Efficacy ◽  
Donor Site ◽  
Fusion Rate ◽  
Iliac Bone ◽  
Anterior Cervical Discectomy ◽  
Allogeneic Bone ◽  
Cervical Discectomy ◽  
Cage Subsidence ◽  
Group A ◽  
Group B

Abstract Purpose To investigate the efficacy and safety of allograft and hydroxyapatite (HA) as substitutes for autograft in anterior cervical discectomy and fusion (ACDF). Methods In this study, 49 patients (80 segments) treated with ACDF were included and allocated into three groups [group A, autogenous iliac bone, n = 18; group B, allogeneic bone, n = 16; group C, HA, n = 15]. The clinical efficacy and fusion status were compared among each group. Complications were recorded in detail, and the Bazaz classification and Voice Handicap Index-10 (VHI-10) were used to detect dysphagia and dysphonia. Results Patients exhibited similar clinical efficacy among the groups during the final follow-up. All patients in groups A and B achieved fusion compared to only 73.3% of patients in group C. Groups A and B had similar fusion score, both of which greater than that of group C. No cage subsidence was observed in group A; however, 6.3% of patients in group B and 53.3% in group C had cage subsidence. Two patients in group A (11.1%) had persistent pain at the donor site. One patient in group B had dysphagia and dysphonia (6.3%), while one patient in group C had dysphonia (6.7%). Conclusion In ACDF, the autogenous iliac bone was the most ideal bone graft. The allogeneic bone was an acceptable substitute but risked cage subsidence and dysphagia. HA had a much lower fusion rate and a high risk of cage subsidence. Better substitutes should be further explored for ACDF.

RADIOGRAPHIC OUTCOMES OF ANTERIOR CERVICAL DISCECTOMY AND FUSION SURGERY BY USING CUSHIONED TITANIUM CAGE

2020 ◽  
Vol 23 (02) ◽  
pp. 2050007
Author(s):  
Jung-Tung Liu ◽  
Se-Yi Chen ◽  
Cheng-Hsing Su ◽  
Tsung-Hsi Yang
Keyword(s):  
Bone Growth ◽  
Standard Procedure ◽  
Anterior Cervical Discectomy ◽  
Disc Disease ◽  
Cervical Discectomy ◽  
Titanium Cage ◽  
Bony Fusion ◽  
Cage Subsidence ◽  
Different Levels

Purpose: Anterior cervical discectomy and fusion is considered as a standard procedure for treating cervical degenerative disc disease. This retrospective study aimed to analyze the radiographic outcome of using a novel cushion titanium cage (Baui Z-Brace Dynamic Fusion Cage). Methods: Fifty-seven patients who received either single-, double-, or three-level interbody fusion surgeries were enrolled. Data from initial status after surgery and postoperative follow-ups for five years were obtained. The patients were divided into three groups according to different levels of cage implantation: 1-level ([Formula: see text]), 2-level ([Formula: see text]), and 3-level ([Formula: see text]). Follow-up time and fusion rate of radiographs were subjected to evaluation. Results: The lateral view of plain radiographs manifests no evident cage subsidence ([Formula: see text][Formula: see text]mm) and dislodgment in 1-, 2-, and 3-level cage implantation. The follow-up time is three years in 1-level and two years in 2- and 3-level. The CT scans at the final follow-up among different levels of cage implantation manifested bony fusion. The measurement of the Hounsfield unit indicates the bone growth inside the cage compared with control case, demonstrating solid bony fusion among groups at the final follow-up. Conclusions: The data confirm that the specialized Z-shaped structure of the cushion titanium cage may provide the interfragmentary motion stimulating innate bony fusion for sustained improvement.

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