G Matgé1. 1. Department of Neurosurgery, Centre Hospitalier de Luxembourg, Luxembourg.
Abstract
BACKGROUND: Anterior decompression with interbody fusion is the surgical procedure of choice in cervical spondylosis. Graft harvesting complications occurring from classical fusion procedures favoured ongoing development of cage technology. To evaluate efficiency of cage fusion for surgical treatment of discogenic cervical disorders, this six-year retrospective study analyses 250 consecutive cases treated by interbody cage fusion with 5 different implants. METHODS: Indications for fusion concerned degenerative discopathies, disc herniations and selected cases of failed surgery presenting with radiculopathy (228 cases) or myelopathy (22 cases). Screwed threaded titanium cages (149 cases), impacted squared or anatomically shaped Peek cages (59 cases), and impacted titanium cages (42 cases) were used together with local graft or bone substitute. Additional plating was indicated in 16 unstable cases. FINDINGS: Excellent outcome for neck pain (96%) and radiculopathy (97%) was noted, but a less favourable one for myelopathy (60%). All cases were stabilised at 1 year. Complications leading to reoperation included cage migration and subsidence, adjacent level degeneration and stenotic myelopathy. INTERPRETATION: Cage technology simplified anterior cervical interbody fusion and proved efficient. The fact there was no graft harvesting saved operating time and hospital stay. STATEMENT: It is not the intention of the author to indicate material preference in this article.
BACKGROUND: Anterior decompression with interbody fusion is the surgical procedure of choice in cervical spondylosis. Graft harvesting complications occurring from classical fusion procedures favoured ongoing development of cage technology. To evaluate efficiency of cage fusion for surgical treatment of discogenic cervical disorders, this six-year retrospective study analyses 250 consecutive cases treated by interbody cage fusion with 5 different implants. METHODS: Indications for fusion concerned degenerative discopathies, disc herniations and selected cases of failed surgery presenting with radiculopathy (228 cases) or myelopathy (22 cases). Screwed threaded titanium cages (149 cases), impacted squared or anatomically shaped Peek cages (59 cases), and impacted titanium cages (42 cases) were used together with local graft or bone substitute. Additional plating was indicated in 16 unstable cases. FINDINGS: Excellent outcome for neck pain (96%) and radiculopathy (97%) was noted, but a less favourable one for myelopathy (60%). All cases were stabilised at 1 year. Complications leading to reoperation included cage migration and subsidence, adjacent level degeneration and stenotic myelopathy. INTERPRETATION: Cage technology simplified anterior cervical interbody fusion and proved efficient. The fact there was no graft harvesting saved operating time and hospital stay. STATEMENT: It is not the intention of the author to indicate material preference in this article.
Authors: Ivan Vladislavov Panayotov; Valérie Orti; Frédéric Cuisinier; Jacques Yachouh Journal: J Mater Sci Mater Med Date: 2016-06-03 Impact factor: 3.896