Comparison of surgical outcomes after anterior cervical discectomy and fusion: does the intra-operative use of a microscope improve surgical outcomes

Adogwa, Owoicho; Elsamadicy, Aladine A.; Reiser, Elizabeth; Ziegler, C.; Freischlag, Kyle; Cheng, Joseph; Bagley, Carlos A.

doi:10.21037/jss.2016.01.04

Cited by 17 publications

(12 citation statements)

References 16 publications

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“…25 A recent publication on microscope and non-microscope ACDF patients revealed an average NDI of 25.04% (microscope group) and 26.54% (non-microscope group). 41 Forty-eight patients considered their outcome as good or excellent (96%), only two patients said that their result was unsatisfactory (4%). The result option "bad" was not chosen by any of the patients.…”

Section: Discussionmentioning

confidence: 99%

Follow-up of a new titanium-coated polyetheretherketone cage for the cervical spine

Arregui¹,

Aso²,

Quiñones³

et al. 2020

Orthop Rev (Pavia)

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Poly-ether-ether-ketone (PEEK) cages have lower modulus of elasticity when compared with Titanium (TTN) cages. This suggests that PEEK-cages could show a lower rate of subsidence after anterior cervical discectomy-fusion (ACDF) and might lead to a lower loss of correction. We investigated the one to five year-results of standalone PEEK-TTN-porous coated cages in a patient cohort from 2014 to 2017. The patients underwent single-level ACDF for disc herniation and degenerative discopathy. Clinical and radiological outcome were assessed in 50 eligible patients after a mean of 27 months. Results: Solid arthrodesis was found in 84%. Neck disability index (NDI), and visual analogue scale (VAS) of neck and arm show comparable results to the literature. Conclusions: Clinical and radiological outcomes of ACDF with PEEK-body-cages with a porous coated surface show good bony integration. The modulus of elasticity, design, shape, size, cage surface architecture, as well as bone density, endplate preparation, radical microdiscectomy and distraction during surgery should be considered as important factors influencing the clinical results. One main advantage, over titanium cages, is the absence of MRI artifacts, allowing an excellent postoperative follow-up.

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Section: Discussionmentioning

confidence: 99%

Follow-up of a new titanium-coated polyetheretherketone cage for the cervical spine

Arregui¹,

Aso²,

Quiñones³

et al. 2020

Orthop Rev (Pavia)

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“…However, there are some limitations in microscope including depth of eld, illumination, and ergonomics when working in deep corridors [15]. Moreover, di cult maneuverability and encumbrance over the operative eld are the motivations for the limited use of microscope during spinal procedures [16]. These limitations can in uence the comfort of the surgeon and the surgical outcome [25].…”

Section: Discussionmentioning

confidence: 99%

“…However, although providing direct binocular and stereoscopic vision, limitations of the operating microscope can include depth of eld, illumination, and ergonomics when working in deep corridors [15]. Furthermore, di cult maneuverability and encumbrance on the operative eld are the major motivations for the limited use of a microscope in spinal procedures, particularly when dedicated surgical instruments need to be implanted [16]. To overcome these shortcomings, a novel visualization tool is required.…”

Section: Introductionmentioning

confidence: 99%

Application of a three-dimensional high-definition exoscope in minimally invasive transforaminal lumbar interbody fusion

Yao

Xiong²,

Huang³

et al. 2020

Preprint

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Background Minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) is becoming increasingly popular in the treatment of lumbar degenerative diseases. Microscope assisted MIS-TLIF was also reported favorable clinical outcomes and low complication rates, while limitations can include depth of field, illumination, and ergonomics. The exoscope has been introduced as an alternative to microscopes. In this report, we describe the application of the 3-dimensional (3D), high-definition (HD) exoscope for MIS-TLIF, and discuss its advantages and disadvantages. Methods Six patients were performed 3D-HD exoscope-assisted MIS-TLIF from September 2019 to December 2019. The exoscope was used [Kestrel View II, WEALTH CONCORD MITAKA MEDICAL TECHNOLOGIESCO., LTD. OF SHANGHAI, CHINA] during soft tissue dissection, discectomy, decompression, and cage insertion. Results The exoscope provided an excellent 3D view of the surgical field and allowed us to effectively and safely perform the surgical steps. All 6 patients experienced excellent surgical outcomes. The main advantages of the 3D exoscope include the possibility to provide excellent, magnified, and illuminated 3D-HD images of the surgical field to the entire operating room and serving as an excellent training tool. Conclusion We believe that the 3D exoscope will be a safe and effective tool to perform MIS-TLIF.

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“…Complication and reoperation rates in this study were lower than previously reported rates, which were as high as 10%–13%. [1,3,4,8,10] The discrepancy is most likely attributed to a shorter follow-up period. Notably, our results showed that additional instrumentation is not significantly associated with adverse events including infection, soft tissue injury, or neurological deficit.…”

Section: Discussionmentioning

confidence: 99%

Comparison of 30-day outcome following anterior cervical discectomy and fusion with or without instrumentation for cervical spondylosis: A review of 2352 elective cases

Lim

Haider

Zakaria

et al. 2019

Surgical Neurology International

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Background:Anterior cervical discectomy and fusion (ACDF) is a commonly performed procedure to address cervical myeloradiculopathy. However, 30-day outcomes after additional plating/instrumentation are not very clear.Methods:The authors reviewed The National Surgical Quality Improvement Program database to identify all elective ACDF cases with or without instrumentation for patients having cervical spondylosis with or without myelopathy from 2011 to 2013 using current procedural terminology and International Classification of Disease-9 codes. We identified 2352 cases and subdivided these into two cohorts based on instrumentation procedures (588 cases without instrumentation and 1764 cases with instrumentation). Baseline differences in two cohorts were adjusted by propensity score matching analysis, yielding well-matched 583 pairs.Results:Following propensity matching, the authors observed no significant difference in 30-day complication rates (prematch, 2.4% vs. 2.4%; and postmatch, 2.4% vs. 1.7%), readmission (prematch, 4.1% vs. 3.2%; and postmatch, 3.9% vs. 3.3%), and reoperation (prematch 0.9% vs. 1.8%; and postmatch 0.9% vs. 1.5%).Conclusion:Our results demonstrate similar 30-day outcomes in both cohorts and suggest that instrumentation can be safely implemented in the setting of ACDF.

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Comparison of surgical outcomes after anterior cervical discectomy and fusion: does the intra-operative use of a microscope improve surgical outcomes

Cited by 17 publications

References 16 publications

Follow-up of a new titanium-coated polyetheretherketone cage for the cervical spine

Follow-up of a new titanium-coated polyetheretherketone cage for the cervical spine

Application of a three-dimensional high-definition exoscope in minimally invasive transforaminal lumbar interbody fusion

Comparison of 30-day outcome following anterior cervical discectomy and fusion with or without instrumentation for cervical spondylosis: A review of 2352 elective cases

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