Cervical Stand-Alone Polyetheretherketone Cage versus Zero-Profile Anchored Spacer in Single-Level Anterior Cervical Discectomy and Fusion : Minimum 2-Year Assessment of Radiographic and Clinical Outcome

Cho, Hyun Jun; Hur, Junseok W.; Lee, Jang Bo; Han, Jin Sol; Cho, Tai Hyoung; Park, Jung Youl

doi:10.3340/jkns.2015.58.2.119

Cited by 31 publications

(41 citation statements)

References 27 publications

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“…They found fusion was achieved in 93.5% of patients after a median follow-up of 23 months. In the other 12 articles, the analysis was performed by a clinician, usually a neuro-or orthopaedic surgeon [12,29,35,61,67,69,87,92,96,[109][110][111]. They found fusion was achieved in 85.5% of patients after a median follow-up of 23 months.…”

Section: Methods Of Measuring Bony Fusionmentioning

confidence: 99%

Evaluation of bony fusion after anterior cervical discectomy: a systematic literature review

2018

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Purpose Anterior cervical discectomy and fusion (ACDF) has proven effective in treating radicular arm pain. Post-operatively, cervical spine stability is temporarily challenged, but data on bony fusion and speed of fusion are ambiguous; optimum evaluation method and criteria are debated. Aim To study bony fusion accomplishment and to obtain an overview of methods to evaluate fusion. Methods A literature search was performed in PubMed and Embase. Included studies had to report original data concerning 1-or 2-level ACDF with intervertebral device or bone graft, where bony fusion was assessed using CT scans or X-rays. Results A total of 146 articles comprising 10,208 patients were included. Bony fusion was generally defined as "the presence of trabecular bridging" and/or "the absence of motion". Fusion was accomplished in 90.1% of patients at the final follow-up. No gold standard for assessment could be derived from the results. Addition of plates and/or cages with screws resulted in slightly higher accomplishment of fusion, but differences were not clinically relevant. Eighteen studies correlated clinical outcome with bony fusion, and 3 found a significant correlation between accomplishment and better clinical outcome. Conclusions In approximately 90% of patients, bony fusion is accomplished one year after ACDF. As there is no generally accepted definition of bony fusion, different measuring techniques cannot be compared to a gold standard and it is impossible to determine the most accurate method. Variations in study design hamper conclusions on optimising the rate of bony fusion by choice of material and/or additives. Insufficient attention is paid to correlation between bony fusion and clinical outcome.Graphical abstract These slides can be retrieved from electronic supplementary material.

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Section: Methods Of Measuring Bony Fusionmentioning

confidence: 99%

Evaluation of bony fusion after anterior cervical discectomy: a systematic literature review

2018

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“…Previously, Cho et al4) reported that the PEEK-titanium combined anchored cage showed a statistically better outcome in Cobb angle, disc height, subsidence rate than the stand-alone cage. Furthermore, Song et al24) reported that anterior cervical cage-plate is more beneficial with regard to postoperative results than the stand-alone cage.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Radiologic Outcomes of Different Methods in Single-Level Anterior Cervical Discectomy and Fusion

et al. 2016

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ObjectiveAnterior cervical discectomy and fusion (ACDF) is a choice of surgical procedure for cervical degenerative diseases associated with radiculopathy or myelopathy. However, the patients undergoing ACDF still have problems. The purpose of the present study is to evaluate the radiologic results of 3 different methods in single-level ACDF.MethodsWe conducted a retrospective collection of radiological data from January 2011 to December 2014. A total of 67 patients were included in this study. The patients were divided into 3 groups by operation procedure: using stand-alone cage (group cage, n=20); polyether-ether-ketone (PEEK)-titanium combined anchored cage (group AC, n=21); and anterior cervical cage-plate (group CP, n=26). Global cervical lordosis (C2-C7 Cobb angle), fused segment height, fusion rate, and cervical range of motion (ROM) were measured and analyzed at serial preoperative, postoperative, 6-month, and final 1-year follow-up.ResultsSuccessful bone fusion was achieved in all patients at the final follow-up examination; however, the loss of disc height over 3 mm at the surgical level was observed in 6 patients in group cage. Groups AC and CP yielded significantly better outcomes than group cage in fused segment height and cervical ROM(p=0.01 and p=0.02, respectively). Furthermore, group AC had similar radiologic outcomes to those of group CP.ConclusionThe PEEK-titanium combined anchored cage may be a good alternative procedure in terms of reducing complications induced by plate after ACDF.

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“…A zero-profile device is thought as a valuable alternative for ACDF with a low incidence of postoperative dysphagia and without segmental kyphotic change (34). Cho et al found that the zero-profile anchored spacer has some advantage over stand-alone PEEK cage for maintaining segmental lordosis and lowering subsidence rate after single level ACDF (35). Barbagallo et al mentioned that SF-36 and NDI showed a statistically significant improvement and mean arm pain VAS score deterioration on zero-profile cage-plate device.…”

Section: Discussionmentioning

confidence: 99%

Single anterior cervical discectomy and fusion (ACDF) using self- locking stand-alone polyetheretherketone (PEEK) cage: evaluation of pain and health-related quality of life

Kapetanakis¹,

Thomaidis²,

Charitoudis³

et al. 2017

J. Spine Surg.

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Background: Anterior cervical discectomy and fusion (ACDF) constitutes the conventional treatment of cervical disc herniation due to degenerative disc disease (DDD). ACDF with plating presents a variety of complications postoperatively and stand-alone cages are thought to be a promising alternative. The aim of this study was firstly, to analyze prospectively collected data from a sample of patients treated with single ACDF using C-Plus self-locking stand-alone PEEK cage system, without the use of plates or screws, in order to evaluate pain levels of patients, utilizing Neck and Arm Pain scale as an expression of visual analogue scale (VAS). Secondly, we aimed to evaluate health-related quality of life, via the short-form 36 (SF-36) and Neck Disability Index (NDI).Methods: Thirty-six patients (19 male and 17 female) with mean age 49.6±7 years old who underwent successful single ACDF using self-locking stand-alone PEEK cage for symptomatic cervical DDD were selected for the study. Neck and Arm pain, as well as SF-36 and NDI were estimated preoperatively and 1, 3, 6, and 12 months postoperatively. Patients underwent preoperative and postoperative clinical, neurological and radiological evaluation. Results:The clinical and radiological outcomes were satisfactory after a minimum 1-year follow-up.All results were statistically important (P<0.05), excluding improvement in NDI measured between 6 and 12 months. SF-36, Neck Pain, as well as Arm Pain featured gradual and constant improvement during follow-up, with best scores presenting at 12 months after surgery, while NDI reached its best at 6 months postoperatively.Conclusions: Generally, all scores showed improvement postoperatively during the different phases of the follow-up. Subsequently, ACDF using C-Plus cervical cage constitutes an effective method for cervical disc herniation treatment, in terms of postoperative improvement on pain levels and health-related quality of life and a safe alternative to the conventional method of treatment for cervical DDD.

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Cervical Stand-Alone Polyetheretherketone Cage versus Zero-Profile Anchored Spacer in Single-Level Anterior Cervical Discectomy and Fusion : Minimum 2-Year Assessment of Radiographic and Clinical Outcome

Cited by 31 publications

References 27 publications

Evaluation of bony fusion after anterior cervical discectomy: a systematic literature review

Evaluation of bony fusion after anterior cervical discectomy: a systematic literature review

Comparison of Radiologic Outcomes of Different Methods in Single-Level Anterior Cervical Discectomy and Fusion

Single anterior cervical discectomy and fusion (ACDF) using self- locking stand-alone polyetheretherketone (PEEK) cage: evaluation of pain and health-related quality of life

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