Long-Term Follow-Up Results of Anterior Cervical Inter-Body Fusion with Stand-Alone Cages

Kim, Woong-Beom; Hyun, Seung-Jae; Choi, Hoyong; Kim, Ki-Jeong; Jahng, Tae-Ahn; Kim, Hyun-Jib

Long-Term Follow-Up Results of Anterior Cervical Inter-Body Fusion with Stand-Alone Cages

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Type: Academic journal

Author: Kim, Woong-Beom (Department of Neurosurgery, Spine Center, Seoul National University Bundang Hospital, Seoul National University College of Medicine) Hyun, Seung-Jae (Department of Neurosurgery, Spine Center, Seoul National University Bundang Hospital, Seoul National University College of Medicine)

Journal: 대한신경외과학회 대한신경외과학회지 대한신경외과학회지 제59권 제4호 SCOPUS

Published: 2016.1

Pages: 385 - 391 (7page)

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Long-Term Follow-Up Results of Anterior Cervical Inter-Body Fusion with Stand-Alone Cages

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Objective : The purpose of this study was to evaluate long-term follow-up radiologic/clinical outcomes of patients who underwent anterior cervical discectomy and inter-body fusion (ACDF) with stand-alone cages (SAC) in a single academic institution. Methods : Total 99 patients who underwent ACDF with SAC between February 2004 and December 2012 were evaluated retrospectively. A total of 131 segments were enrolled in this study. Basic demographic information, radiographic [segmental subsidence rate, fusion rate, C2-7 global angle, and segmental angle changes)/clinical outcomes (by Odom's criteria and visual analog score (VAS)] and complications were evaluated to determine the long-term outcomes. Results : The majority were males (55 vs. 44) with average age of 53.2. Mean follow-up period was 62.9 months. The segmental subsidence rate was 53.4% and fusion rate was 73.3%. In the subsidence group, anterior intervertebral height (AIH) had more tendency of subsiding than middle or posterior intervertebral height (p=0.01). The segmental angle led kyphotic change related to the subsidence of the AIH. Adjacent segmental disease was occurred in 18 (18.2%) patients. Total 6 (6%) reoperations were performed at the index level. There was no statistical significance between clinical and radiological outcomes. But, overall long-term clinical outcome by Odom's criteria was unsatisfactory (64.64%). The neck and arm VAS score were increased by over time. Conclusion : Long-term outcomes of ACDF with SAC group were acceptable but not satisfactory. For optimal decision making, more additional comparative long-term outcome data is needed between ACDF with SAC and ACDF with plating.

#Anterior cervical discectomy and fusion #Stand-alone cage #Subsidence #Long-term outcomes #Intervertebral height #Odom's criteria

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References (25)

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Brenke C / 2015 / Influence of cervical bone mineral density on cage subsidence in patients following stand-alone anterior cervical discectomy and fusion / Eur Spine J 24:2832~2840

Burkhardt JK / 2015 / The influence of cervical plate fixation with either autologous bone or cage insertion on radiographic and patient-rated outcomes after two-level anterior cervical discectomy and fusion / Eur Spine J 24:113~119

Cabraja M / 2012 / Anterior cervical discectomy and fusion : comparison of titanium and polyetheretherketone cages / BMC Musculoskelet Disord 13:172

Cannada LK / 2003 / Pseudoarthrosis of the cervical spine : a comparison of radiographic diagnostic measures / Spine 28:46~51

Fujibayashi S / 2008 / Stand-alone interbody cage versus anterior cervical plate for treatment of cervical disc herniation : sequenTabletial changes in cage subsidence / J Clin Neurosci 15:1017~1022

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Kim, Woong-Beom

Affiliation Department of Neurosurgery, Spine Center, Seoul National University Bundang Hospital, Seoul National