Disc Replacement Adjacent to Cervical Fusion

Lee, Michael J.; Dumonski, Mark; Phillips, Frank M.; Voronov, Leonard I.; Renner, Susan M.; Carandang, Gerard; Havey, Robert M.; Patwardhan, Avinash G.

doi:10.1097/brs.0b013e3181fc1aff

Cited by 64 publications

(23 citation statements)

References 19 publications

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“…However, only 1 type of hybrid surgery was investigated [ 9 ]. Lee et al [ 12 ], in a biomechanical study of 2 approaches of hybrid surgery using 3 cadaveric cervical spines, showed that the location of the single-level fusion, above or below the arthroplasty, did not significantly affect the ROM and could reduce hypermobility in adjacent-level. Cho et al[ 10 ] used cadaveric spine specimens to explore biomechanics under a compressive load after 2 types of hybrid surgery; results demonstrated no significant change in ROM at adjacent levels or in the entire cervical spine when comparing both types of surgery with the intact spine.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Hybrid Constructs with 2-Level Artificial Disc Replacement and 2-Level Anterior Cervical Discectomy and Fusion for Surgical Reconstruction of the Cervical Spine: A Kinematic Study in Whole Cadavers

2015

Med Sci Monit

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BackgroundMulti-level cervical degeneration of the spine is a common clinical pathology that is often repaired by anterior cervical discectomy and fusion (ACDF).The aim of this study was to investigate the kinematics of the cervical spine after hybrid surgery compared with 2-level ACDF.Material/MethodsFive freshly frozen, unembalmed whole human cadavers were used including 3 males and 2 females with a mean age of 51±8 years. After evaluating the intact spine for range of motion (ROM), sagittal alignment and instantaneous center of rotation (ICR), each cadaver underwent 4 consecutive surgeries: 2-level artificial disc replacement (ADR) from C4 to C6 (ADR surgery); 2-level ACDF from C4 to C6 (ACDF surgery); hybrid C4–5 ACDF and C5–6 ADR (ACDF+ADR surgery); and hybrid C4–5 ADR and C5–6 ACDF (ADR+ACDF surgery). The ROM and ICR of adjacent intact segments (C3–4; C6–7), and whole sagittal alignment were revaluated.ResultsTwo-level ACDF resulted in increased ROM at C3–4 and C6–7 compared with intact spine. ROM was significantly different to intact spine using ACDF surgery at C3–C4 and C6–C7 and ROM was increased with ACDF+ADR surgery at C6–C7 (all P<0.05). No improvement in sagittal alignment was observed with any approach. The localization of the ICR shifted upwards and anteriorly at C3–C4 after reconstruction. ICR changes at C3–C4 were greatest for ADR+ACDF surgery and were significantly different to ACDF surgery (P<0.05), but not between ADR surgery and ACDF+ADR surgery. At C6–C7, the ICR was more posterior and superior than in the intact condition. The greatest change in ICR was observed in ACDF surgery at the C6–C7 level, significantly different from the other groups (P<0.05).ConclusionsFor 2-level reconstruction, hybrid surgery and ADR did not alter ROM and minimally changed ICR at the adjacent-level. The type of surgery had a significant impact on the ICR location. This suggests that hybrid surgery may be a viable option for 2-level cervical surgery.

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Section: Discussionmentioning

confidence: 99%

Comparison of Hybrid Constructs with 2-Level Artificial Disc Replacement and 2-Level Anterior Cervical Discectomy and Fusion for Surgical Reconstruction of the Cervical Spine: A Kinematic Study in Whole Cadavers

2015

Med Sci Monit

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“…ROMs of our FEMs in flexion-extension, lateral bending, and axial rotation were compared with the data from previous studies [8,[18][19][20]. The ROMs of the intact FEMs at C2/3, C3/4, C4/5, C5/6, and C6/7 were 4.11°± 0.75°, 5.22°± 1.10°, 5.74°± 1.08°, 5.70°± 1.11°, and 4.39°± 0.94°, respectively, in flexion; 3.24°± 0.79°, 4.23°± 1.03°, 4.65°± 1.01°, and 4.04°± 1.03°, respectively, in extension; 5.15°± 0.85°, 4.84°± 1.15°, 4.73°± 1.29°, 3.42°± 0.77°, and 2.63°± 0.58°, respectively, in lateral bending; and 2.04°± 0.83°, 2.97°± 0.79°, 3.73°± 0.67°, 3.14°± 0.62°, and 2.20°± 0.93°, respectively, axial rotation (Fig.…”

Section: Validation Of the Intact Femsmentioning

confidence: 99%

Biomechanical comparison of noncontiguous cervical disc arthroplasty and noncontiguous cervical discectomy and fusion in the treatment of noncontinuous cervical degenerative disc disease: a finite element analysis

Sun

Zhang

et al. 2020

J Orthop Surg Res

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Background: Biomechanical characteristics of noncontinuous ACDF and noncontinuous CDA in the treatment of noncontinuous cervical degenerative disc disease were still unclear. The aim of this research is to compare the differences between these two kinds of treatment methods and to verify the effectiveness of Prodisc-C in noncontinuous CDA. Methods: Eight FEMs of the cervical spine (C2-C7) were built based on CT images of 8 mild CDDD volunteers. In the arthroplasty group, we inserted Prodisc-C at C3/4 and C5/6. In the fusion group, CoRoent® Contour and NuVasive® Helix ACP were implanted at C3/4 and C5/6. Initial loads of 75 N were used to simulate the head weight and muscle forces. The application of 1.0 N m moment on the top on the C2 vertebra was used to create motion in all directions. Statistical analyses were performed using STATA version 14.0 (Stata Corp LP, College Station, Texas, USA). Statistical significance was set at P < 0.05. Results: The IDPs in C2/3 (P < 0.001, P = 0.005, P < 0.001, P < 0.001), C4/5 (P < 0.001), and C6/7 (P < 0.001) of the intact group were significantly less than that in the fusion group in flexion, extension, lateral bending, and axial rotation, respectively. In addition, the IDPs in C2/3 (P < 0.001, P = 0.001, P < 0.001, P < 0.001), C4/5 (P < 0.001), and C6/7 (P < 0.001) of the arthroplasty group were significantly less than that in the fusion group in flexion, extension, lateral bending, and axial rotation, respectively. Contact forces of facet joints in C2/3 (P = 0.010) in the arthroplasty group was significantly less than that in the intact group. Contact forces of facet joints in C2/3 (P < 0.001), C4/5 (P < 0.001), and C6/7 (P < 0.001) in the arthroplasty group was significantly less than that in the fusion group. Contact forces of facet joints in C2/3 (P < 0.001), C4/5 (P < 0.001), and C6/7 (P < 0.001) in the intact group were significantly less than that in the fusion group.

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“…[3–6] The selection of optimal surgical treatment for CSM, especially for multilevel cervical spondylotic myelopathy (mCSM), remains controversial. [1–9] Surgeries mainly involved anterior and posterior approaches, including anterior cervical discectomy and fusion (ACDF), [10–12] anterior cervical corpectomy and fusion (ACCF), [11–15] laminoplasty, [16–20] laminectomy, [12,18–22] and laminectomy with fusion. [20–23] ACDF for treating CSM was firstly introduced by Smith and Robinson [24] and Cloward [25] ; the anterior procedure has become the most widely used surgical choice.…”

Section: Introductionmentioning

confidence: 99%

Anterior cervical discectomy and fusion versus anterior cervical corpectomy and fusion in multilevel cervical spondylotic myelopathy

Wang

Liu

et al. 2016

Medicine

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Background:Both anterior cervical discectomy and fusion (ACDF) and anterior cervical corpectomy and fusion (ACCF) are used to treat multilevel cervical spondylotic myelopathy (mCSM); however, which one is better treatment for mCSM remains considerable controversy. A meta-analysis was performed to compare clinical outcomes, radiographic outcomes, and surgical outcomes between ACDF and ACCF in treatment for mCSM.Methods:An extensive search of literature was performed in Pubmed/MEDLINE, Embase, the Cochrane library, CNKI, and WANFANG databases on ACDF versus ACCF treatment for mCSM from January 2011 to August 2016. The following variables were extracted: length of hospital stay, blood loss, operation time, Japanese Orthopedic Association (JOA) scores, Neck Disability Index (NDI) score, fusion rate, Cobb angles of C2 to C7, dysphagia, hoarseness, C5 palsy, infection, cerebral fluid leakage, donor site pain, epidural hematoma, graft subsidence, graft dislodgment, pseudoarthrosis, and total complications. Data analysis was conducted with RevMan 5.3 and STATA 12.0.Results:A total of 8 studies containing 878 patients were included in our study. The results showed that ACDF is better than ACCF in the angle of C2 to C7 at the final follow-up (P < 0.00001, standardized mean difference = 4.76 [3.48, 6.03]; heterogeneity: P = 0.17, I2 = 43%), C5 plasy (P = 0.02, odds ratio [OR] 0.42, 95% confidence interval [CI] 0.21, 0.86; heterogeneity: P = 0.52, I2 = 0%), blood loss (P < 0.00001, standardized mean difference = −53.12, 95% CI −64.61, −41.64; heterogeneity: P = 0.29, I2 = 20%), fusion rate (P = 0.04, OR 2.54, 95% CI 1.05, 6.11; heterogeneity: P = 0.29, I2 = 20%), graft subsidence (P = 0.004, OR 0.11, 95% CI 0.02, 0.48; heterogeneity: P = 0.94, I2 = 0%), and total complications (P = 0.0009, OR 0.56, 95% CI 0.40, 0.79; heterogeneity: P = 0.29, I2 = 18%).However, there are no significant differences in length of hospital stay, operation time, JOA scores, NDI scores, preoperative angle of C2 to C7, dysphagia, hoarseness, infection, cerebral fluid leakage, donor site pain, epidural hematoma, graft dislodgment, and pseudoarthrosis (all P > 0.05).Conclusions:Based on our meta-analysis, our results suggest that both ACDF and ACCF are good plans in clinical outcomes; however, ACDF is a better choice in radiographic outcomes and total complications for the treatment of multilevel CSM.

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Disc Replacement Adjacent to Cervical Fusion

Cited by 64 publications

References 19 publications

Comparison of Hybrid Constructs with 2-Level Artificial Disc Replacement and 2-Level Anterior Cervical Discectomy and Fusion for Surgical Reconstruction of the Cervical Spine: A Kinematic Study in Whole Cadavers

Comparison of Hybrid Constructs with 2-Level Artificial Disc Replacement and 2-Level Anterior Cervical Discectomy and Fusion for Surgical Reconstruction of the Cervical Spine: A Kinematic Study in Whole Cadavers

Biomechanical comparison of noncontiguous cervical disc arthroplasty and noncontiguous cervical discectomy and fusion in the treatment of noncontinuous cervical degenerative disc disease: a finite element analysis

Anterior cervical discectomy and fusion versus anterior cervical corpectomy and fusion in multilevel cervical spondylotic myelopathy

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