Comparative Analysis of Cage Subsidence in Anterior Cervical Decompression and Fusion: Zero Profile Anchored Spacer (ROI-C) vs. Conventional Cage and Plate Construct

Jin, Zhaoyang; Teng, Yun; Wang, Hua-zheng; Yang, Huilin; Lu, Yingjie; Gan, Minfeng

doi:10.3389/fsurg.2021.736680

Cited by 19 publications

(18 citation statements)

References 31 publications

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“…The incidence of subsidence in the PEEK group is within the published range of 14.9-66% [10,[20][21][22][23]; in contrast, the Al 2 O 3 group showed incidence of subsidence below this range.…”

Section: Discussionmentioning

confidence: 57%

Speed and quality of interbody fusion in porous bioceramic Al 2 O 3 and polyetheretherketone cages for anterior cervical discectomy and fusion: a comparative study

Kostysyn

Ryška

Jandura

et al. 2023

Preprint

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Background The objective of this prospective randomized monocentric study is to compare the speed and quality of interbody fusion of implanted porous Al2O3 (aluminium oxide) cages with PEEK (polyetheretherketone) cages in ACDF (anterior cervical discectomy and fusion). Materials and methods A total of 111 patients were enrolled in the study, which was carried out between 2015 and 2021. The 18-month follow-up (FU) was completed in 68 patients with an Al2O3 cage and 35 patients with a PEEK cage in one-level ACDF. Initially, the first evidence (initialization) of fusion was evaluated on computed tomography (CT). Subsequently, interbody fusion was evaluated according to the fusion quality scale, fusion rate and incidence of subsidence. Results Signs of incipient fusion at 3 months were detected in 22% of cases with the Al2O3 cage and 37.1% with the PEEK cage. At 12-month FU, the fusion rate was 88.2% for Al2O3 and 97.1% for PEEK cages, and at the final FU at 18 months, 92.6% and 100%, respectively. The incidence of subsidence was observed to be 11.8% and 22.9% of cases with Al2O3 and PEEK cages, respectively. Conclusions Porous Al2O3 cages demonstrated a lower speed and quality of fusion in comparison with PEEK cages. However, the fusion rate of Al2O3 cages was within the range of published results for various cages. The incidence of subsidence of Al2O3 cages was lower compared to published results. We consider the porous Al2O3 cage as safe for a stand-alone disc replacement in ACDF.

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Section: Discussionmentioning

confidence: 57%

Speed and quality of interbody fusion in porous bioceramic Al 2 O 3 and polyetheretherketone cages for anterior cervical discectomy and fusion: a comparative study

Kostysyn

Ryška

Jandura

et al. 2023

Preprint

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“…In conclusion, we believe that this result was within our expectation, considering that the anterior titanium plates of the ACDF group would provide additional structural reinforcement. Comparing the four-year clinical follow-up of Jin et al ’s28 result, the mean disc height loss in their two groups after surgery was around 1.8 mm, and the cage subsidence rate was higher in the SA group (66.67%) than in the conventional plate group (38.46%). In this retrospective study, we observed that the loss of disk height was higher in the SA cage group than in the CPC group (0.35±0.27 vs. 0.11±0.34 mm) at the five-year follow-up compared with one month postoperation.…”

Section: Discussionmentioning

confidence: 90%

Comparing Clinical and Radiographic Outcomes Between the Self-locking Stand-Alone Cage and Conventional Cage-Plate Construct: a 5-year Retrospective Cohort Study

Lei

Gan

et al. 2022

Spine

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Study Design/Setting. A retrospective cohort study. Objective. To evaluate the clinical efficacy of the self-locking standalone (SA) cage and conventional cage-plate construct (CPC) in treating degenerative cervical spondylosis with a five-year follow-up. Summary of Background Data. The SA approach was designed to reduce complications associated with traditional anterior cervical discectomy and fusion. These techniques have been shown to have satisfactory short-term clinical outcomes. Literature describing the mid-term clinical outcomes of SA cage is limited. Materials and Methods. We retrospectively analyzed patients with cervical spondylosis who had received an SA device or CPC between 2014 and 2016 at the Xijing Hospital. Participants were matched for sex, age, and operative level. Differences in clinical and radiographic outcomes and the occurrence of postoperative complications between the two groups were analyzed. Results. In total, 207 patients were included (101 with SA and 106 with CPC), the median follow-up for both groups were 60.2 and 60.9 months. Both groups exhibited significant improvements in all measured values compared with the preoperative values. The SA group had a shorter operation time, less intraoperative blood loss, and a significantly lower incidence of dysphagia after surgery than the CPC group (P < 0.05). At the last visit, cage subsidence was 6.9% and 3.8% in the SA and CPC groups, respectively (P = 0.365). The radiographic adjacent segment degeneration (ASD) was significantly lower in the SA group than in the CPC group (6.9% vs. 27.4%, P < 0.01). No symptomatic ASD was observed in the SA group, and six (5.7%) cases occurred in the CPC group (P = 0.029). Conclusions. In this study, the SA cage showed similar efficacy to that of the conventional CPC in treating cervical spondylosis using anterior cervical discectomy and fusion, with a significant reduction in the incidence of immediate postoperative dysphagia and mid-term ASD.

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“…Similarly, Pinder et al 19 also demonstrated increased subsidence in ACDF without reliable instrumentation. Meanwhile, Jin et al 20 further investigated the effect of zero-profile cages and conventional cage-plate combination on postoperative subsidence and showed increased subsidence by the former, demonstrating the incidence of subsidence to be associated with instrument's rigidity. Therefore, it seemed plausible to conclude that both instrument's presence and strength played an important role in the initiation of subsidence.…”

Section: Discussionmentioning

confidence: 99%

“…also demonstrated increased subsidence in ACDF without reliable instrumentation. Meanwhile, Jin et al 20 . further investigated the effect of zero‐profile cages and conventional cage‐plate combination on postoperative subsidence and showed increased subsidence by the former, demonstrating the incidence of subsidence to be associated with instrument's rigidity.…”

Section: Discussionmentioning

confidence: 99%

Reverse Lumbar Pedicle Screw in Oblique Lateral Interbody Fusion: A Novel Concept to Restrict Cage Subsidence

He,

Luo,

Fang

et al. 2023

Orthopaedic Surgery

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ObjectiveCage subsidence is a common morbidity after oblique lumbar interbody fusion (OLIF), with risk of compromising clinical and radiographic outcomes. The study aims to describe an innovative reverse lumbar pedicle screw (RLPS) technique in OLIF and compare its effect on restricting cage subsidence with classical lateral fixation (LF) in radiological and clinical evaluation.MethodConsecutive patients having undergone single‐level OLIF‐LF/RLPS from 2018 to 2020 were retrospectively reviewed. In OLIF‐RLPS, the upper entry point was determined at the intersection between one horizontal line (1 cm above inferior endplate) and one vertical line (dissecting anterior and middle thirds of the vertebra) while the inferior entry point between one horizontal line (5 mm below superior endplate) and the same vertical line. Trajectories were from vertebrae reverse into contralateral pedicle. Radiological evaluation included disc height (DH) and segmental lordosis (SL); cage subsidence was evaluated by DH loss. Clinical assessment included visual analogue scale (VAS) and Oswestry disability index (ODI). Student t or Mann–Whitney U test was used for continuous variation according to normality analysis while Chi‐square test for category variation.ResultsA total of 29 patients had been enrolled in the study including 14 cases in the RLPS group and 15 cases in the LF group. The DH in the OLIF‐RLPS group had increased from the preoperative 9.07 ± 1.73 mm to 13.73 ± 1.83 mm postoperatively, without significant difference compared with the OLIF‐LF group during the perioperative, but decreased to 12.53 ± 1.74 mm in 3 months and maintained at 12.00 ± 1.45 mm in 12 months, significantly higher than the OLIF‐LF group (p < 0.05). At the last follow‐up, 7.1% (1/14) cases in the OLIF‐RLPS group had shown subsidence of grade I, significantly less than 46.7% (7/15) cases in the OLIF‐LF group. Pain and disability had improved similarly in two groups, without significant difference detected between two groups at the last follow‐up.ConclusionRLPS technique with modified entry points and prolonged trajectory could effectively restrict cage subsidence in OLIF postoperatively compared with traditional lateral fixation.

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Comparative Analysis of Cage Subsidence in Anterior Cervical Decompression and Fusion: Zero Profile Anchored Spacer (ROI-C) vs. Conventional Cage and Plate Construct

Cited by 19 publications

References 31 publications

Speed and quality of interbody fusion in porous bioceramic Al 2 O 3 and polyetheretherketone cages for anterior cervical discectomy and fusion: a comparative study

Speed and quality of interbody fusion in porous bioceramic Al 2 O 3 and polyetheretherketone cages for anterior cervical discectomy and fusion: a comparative study

Comparing Clinical and Radiographic Outcomes Between the Self-locking Stand-Alone Cage and Conventional Cage-Plate Construct: a 5-year Retrospective Cohort Study

Reverse Lumbar Pedicle Screw in Oblique Lateral Interbody Fusion: A Novel Concept to Restrict Cage Subsidence

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