Joseph F Baker1, Jaime Gomez2, Kartik Shenoy3, Sarah Kim4, Afshin Razi3, Yong Kim3. 1. Department of Orthopedic Surgery, Waikato Hospital, Hamilton, New Zealand. 2. Department of Orthopaedic Surgery, Albert Einstein College of Medicine, Bronx, NY, USA. 3. Department of Orthopaedic Surgery, NYU Langone Medical Center Hospital for Joint Diseases, New York, NY, USA. 4. Loma Linda University, School of Medicine, Loma Linda, CA, USA.
Abstract
BACKGROUND: Anterior cervical discectomy and fusion (ACDF) may be performed using an interbody cage or graft with an anterior plate or with a stand-alone (SA) interbody device without the anterior plate. The pros and cons of each vary. This study examined the radiographic outcome of the two techniques with a focus on implant subsidence. METHODS: A retrospective review of cases of singe level ACDF by a single surgeon was undertaken. Medical and radiographic records were reviewed to determine subsidence, pre- and post-operative segmental and total lordosis in cohorts of both stand-alone and graft-and-plate constructs. RESULTS: The post-operative radiographs of 35 patients with a SA cage were compared with 41 patients with an allograft block and anterior plate (graft and plate; GP). There was no significant difference in overall subsidence between the two groups although there was a trend toward less clinically significant subsidence (2 mm) in the SA group. For single level ACDF, a SA device appears to be comparable in terms of undesired subsidence. CONCLUSIONS: Further studies with different implants and materials may offer further insight.
BACKGROUND: Anterior cervical discectomy and fusion (ACDF) may be performed using an interbody cage or graft with an anterior plate or with a stand-alone (SA) interbody device without the anterior plate. The pros and cons of each vary. This study examined the radiographic outcome of the two techniques with a focus on implant subsidence. METHODS: A retrospective review of cases of singe level ACDF by a single surgeon was undertaken. Medical and radiographic records were reviewed to determine subsidence, pre- and post-operative segmental and total lordosis in cohorts of both stand-alone and graft-and-plate constructs. RESULTS: The post-operative radiographs of 35 patients with a SA cage were compared with 41 patients with an allograft block and anterior plate (graft and plate; GP). There was no significant difference in overall subsidence between the two groups although there was a trend toward less clinically significant subsidence (2 mm) in the SA group. For single level ACDF, a SA device appears to be comparable in terms of undesired subsidence. CONCLUSIONS: Further studies with different implants and materials may offer further insight.
Authors: Félix Tomé-Bermejo; Julián A Morales-Valencia; Javier Moreno-Pérez; Juan Marfil-Pérez; Elena Díaz-Dominguez; Angel R Piñera; Luis Alvarez Journal: Clin Spine Surg Date: 2017-06 Impact factor: 1.876
Authors: Innocent Njoku; Marjan Alimi; Lewis Z Leng; Benjamin J Shin; Andrew R James; Sandeep Bhangoo; Apostolos John Tsiouris; Roger Härtl Journal: J Neurosurg Spine Date: 2014-08-08