A Spallone1, P Marchione2, P Li Voti3, L Ferrante4, M Visocchi5. 1. Department of Clinical Neurosciences, Neurological Centre of Latium, Rome, Italy; Chair of Neurosurgery, Department of Biomedicine, University of Rome "Tor Vergata", Rome, Italy. 2. Department of Clinical Neurosciences, Neurological Centre of Latium, Rome, Italy; Section of Neurology C, Department of Medical and Surgical Sciences and Biotechnologies, University of Rome "La Sapienza", Rome, Italy. 3. IRCCS Neuromed Institute, Pozzilli, IS, Italy. Electronic address: pietro.livoti@yahoo.it. 4. Department of Clinical Neurosciences, Neurological Centre of Latium, Rome, Italy. 5. Section of Spinal Neurosurgery, Department of Neurosurgery, "Sacro Cuore" Catholic University, Rome, Italy.
Abstract
BACKGROUND: Limited outcome data suggested a minimal evidence for better clinical and radiographic outcome of polyetheretherketone cages compared with bone grafts in the anterior cervical discectomy and fusion. We proposed a "mini-invasive" surgical technique for harvesting iliac crest grafts that provides bicortical autografts of sufficient size to be used in multilevel cervical procedures and is not associated with long-term significant donor site pain. METHODS: All patients undergoing discectomy and fusion during a three years period were consecutively extracted from computer database and retrospectively evaluated by means of telephonic interview, independently from surgical procedure (iliac crest autograph or prosthesis). Two procedure-blinded neurologists retrieved baseline clinical-demographic data and pre-surgical scores of routinely performed scales for pain and functional abilities. Afterwards, a third blinded neurologist performed clinical follow up by a semi-structured interview including Verbal Analog Scale for pain and Neck Disability Scale for discomfort. RESULTS: 80 patients out of 115 selected cases completed the follow up. 40 patients had been treated by mini-invasive bone graft harvesting and 40 with PEEK cages for cervical fusion. VAS for both neck and arm pain were significantly reduced within groups. Patients did not complaint any significant pain and/or paraesthesias at donor site from the first week after intervention. Neck Disability Scale was significantly lower at the end of follow up in both groups. CONCLUSIONS: "Miniinvasive" bicortical autografts is a less invasive, inexpensive technique to harvest iliac graft that may produce a reduced amount of general and local donor-site complications without outcome differences with prosthetic cages.
BACKGROUND: Limited outcome data suggested a minimal evidence for better clinical and radiographic outcome of polyetheretherketone cages compared with bone grafts in the anterior cervical discectomy and fusion. We proposed a "mini-invasive" surgical technique for harvesting iliac crest grafts that provides bicortical autografts of sufficient size to be used in multilevel cervical procedures and is not associated with long-term significant donor site pain. METHODS: All patients undergoing discectomy and fusion during a three years period were consecutively extracted from computer database and retrospectively evaluated by means of telephonic interview, independently from surgical procedure (iliac crest autograph or prosthesis). Two procedure-blinded neurologists retrieved baseline clinical-demographic data and pre-surgical scores of routinely performed scales for pain and functional abilities. Afterwards, a third blinded neurologist performed clinical follow up by a semi-structured interview including Verbal Analog Scale for pain and Neck Disability Scale for discomfort. RESULTS: 80 patients out of 115 selected cases completed the follow up. 40 patients had been treated by mini-invasive bone graft harvesting and 40 with PEEK cages for cervical fusion. VAS for both neck and arm pain were significantly reduced within groups. Patients did not complaint any significant pain and/or paraesthesias at donor site from the first week after intervention. Neck Disability Scale was significantly lower at the end of follow up in both groups. CONCLUSIONS: "Miniinvasive" bicortical autografts is a less invasive, inexpensive technique to harvest iliac graft that may produce a reduced amount of general and local donor-site complications without outcome differences with prosthetic cages.
Authors: Matthew M Delancy; Aurelia Perdanasari; Matthew J Davis; Amjed Abu-Ghname; Jordan Kaplan; Sebastian J Winocour; Edward M Reece; Alfred Sutrisno Sim Journal: Semin Plast Surg Date: 2021-05-10 Impact factor: 2.314