Long-term randomised comparison between a carbon fibre cage and the Cloward procedure in the cervical spine

Peolsson, Anneli; Vavruch, Ludek; Hedlund, Rune

doi:10.1007/s00586-006-0067-2

Cited by 55 publications

(49 citation statements)

References 29 publications

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“…[1][2][3][4][5][6] Most of these studies are, however, retrospective [1][2][3][4][5][6] and lack patient-centric data such as persisting problems with the activities of daily life resulting from radiculopathy and/or neck pain and dysfunction. Apart from the previously published 6-year follow-up of the present study, 7 we are not aware of any other prospective studies with 5 or more years of follow-up and no other prospective randomized studies with more than 2 years of follow-up. Comparisons between these two surgical methods, the Cloward procedure (CP) and the cervical intervertebral fusion cage (CIFC or Brantigan cage) made at 10 years or more post ACDF have not previously been published, nor have sub-group analyses of healing status and repeat surgery been made.…”

Section: Introductionmentioning

confidence: 81%

“…8 Questionnaires were also completed six years after surgery. 7 Ten years or more after surgery (mean 138 months, SD 10, range 120-154) a further questionnaire was sent to the remaining 90 patients (four had died for unrelated reasons and one had developed a whiplash-associated disorder six weeks after surgery). Seventy-three patients, (34 men and 39 women, mean age 59 years (SD 8.6, range 42-79)), completed the questionnaire (39 patients in the CIFC group and 34 patients in the CP group).…”

Section: Methodsmentioning

confidence: 99%

“…7,8 Healing status (1=fused, 2=pseudarthrosis) was assessed by a radiologist and a spinal surgeon at the 2-year follow-up. 8 Fusion was classified into four types according to the presence or absence of bridging bone anteriorly and/or through the disc space.…”

Section: Parametersmentioning

confidence: 99%

“…8 Earlier follow-up studies 7,8 have not shown any significant difference between CP and CIFC, apart from a higher rate of pseudarthrosis with the CIFC technique.…”

Section: Introductionmentioning

confidence: 96%

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A Comparison Between the Carbon Fiber Cage and the Cloward Procedure in Cervical Spine Surgery

Hermansen

Hedlund

Vavruch

et al. 2011

Spine

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Study design. 10-13 year follow-up of a prospective randomized study. Objectives.To compare the 10-13 year outcomes of anterior cervical decompression and fusion (ACDF) with a cervical intervertebral fusion cage (CIFC), and the Cloward procedure (CP) using a broad clinical and patient-centered assessment.Summary of Background Data. There are few prospective studies and none with a followup of 10 years or more.Methods. Patient questionnaires completed 10 years or more following ACDF. Seventy-three patients (77%) responded. Radiographs were obtained at 2 years. Results.Apart from greater fulfillment of preoperative expectation (p=0.01) and less headache (p=0.005) in the CIFC group compared to the CP group, there were no significant differences in the outcomes of the two surgical methods. Pain intensity improved in comparison to preoperative levels in both the CIFC and CP groups (p<0.0001), but the Neck Disability Index (NDI) only improved in the CIFC group (p=0.04). Only those with a healed fusion benefited from an improved NDI (p=0.02). There was no deterioration in pain intensity or NDI after the 2-year follow-up.Conclusions. The outcomes of the two surgical methods, with a few exceptions, were equal at 10-13 year follow-up, and there was no deterioration in outcome after the 2-year follow-up.Pain intensity improved more than disability, which may indicate that further improvement of physical function requires early more extensive postoperative rehabilitation. Despite persisting disability, repeat surgery was relatively uncommon.Key words: cervical spine, disc, cage, Cloward, outcome.Comparison between CP and CIFC 3 Key points  Apart from greater fulfillment of preoperative expectation and less headache in the CIFC compared to the CP group, there were no significant differences in the outcomes of the two surgical methods ten or more years after surgery. Pain intensity improved in comparison to preoperative levels in both the CIFC and CP groups, but the NDI only improved in the CIFC group. There was no deterioration in outcome after the two-year follow-up. Only patients with a healed fusion benefited from an improved NDI, otherwise the relationship between radiological findings and clinical outcome was weak. Pain intensity improved more than disability, which may indicate that further improvement of physical function requires early postoperative rehabilitation. Despite persisting disability, repeat surgery was relatively uncommon.Comparison between CP and CIFC 4 Mini Abstract/PrécisThe outcomes of the two methods, anterior cervical decompression and fusion with a cervical intervertebral fusion cage and the Cloward procedure were, with a few exceptions, equal at 10-13 year follow-up of a prospective randomized study. There was no deterioration in outcome after the 2-year follow-up.Comparison between CP and CIFC 5

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Section: Introductionmentioning

confidence: 81%

Section: Methodsmentioning

confidence: 99%

Section: Parametersmentioning

confidence: 99%

“…8 Earlier follow-up studies 7,8 have not shown any significant difference between CP and CIFC, apart from a higher rate of pseudarthrosis with the CIFC technique.…”

Section: Introductionmentioning

confidence: 96%

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A Comparison Between the Carbon Fiber Cage and the Cloward Procedure in Cervical Spine Surgery

Hermansen

Hedlund

Vavruch

et al. 2011

Spine

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“…18 For patients with chronic WAD 19,20 or CR, 5-9 these factors have been insufficiently evaluated in relatively small samples that exhibit reduced function. [5][6][7][8][9][19][20][21][22] It is important to investigate whether and to what extent these patient groups differ from a healthy population, and whether there are differences in CR patients regarding the onset of symptoms (suddenly after a special occasion, or slowly progressing) and in WAD patients regarding Quebec classification. 23 Information is contradictory regarding whether or not WAD Grade is related to outcome, 24,25 and to our knowledge the literature lacks studies investigating whether the type of symptom onset in CR patients is related to functional outcome.…”

Section: Introductionmentioning

confidence: 99%

Function in Patients With Cervical Radiculopathy or Chronic Whiplash-Associated Disorders Compared With Healthy Volunteers

Peolsson

Ludvigsson

Wibault

et al. 2014

Journal of Manipulative and Physiological Therapeutics

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Objective The purposes of this study were to examine whether any differences in function and health exist between patients with cervical radiculopathy (CR) due to disk disease scheduled for surgery and patients with chronic whiplash-associated disorders (WADs) and to compare measures of patients' physical function with those obtained from healthy volunteers. Methods This is a cross-sectional study of patients with CR (n = 198) and patients with chronic WAD (n = 215). Patient data were compared with raw data previously obtained from healthy people. Physical measures included cervical active range of motion, neck muscle endurance, and hand grip strength. Self-rated measures included pain intensity (visual analog scale), neck disability (Neck Disability Index), self-efficacy (Self-Efficacy Scale), and health-related quality of life (EuroQol 5-dimensional self-classifier). Results Patient groups exhibited significantly lower performance than the healthy group in all physical measures (P < .0005) except for neck muscle endurance in flexion for women (P > .09). There was a general trend toward worse results in the CR group than the WAD group, with significant differences in neck active range of motion, left hand strength for women, pain intensity, Neck Disability Index, EuroQol 5-dimensional self-classifier, and Self-Efficacy Scale (P < .0001). Conclusions Patients had worse values than healthy individuals in almost all physical measures. There was a trend toward worse results for CR than WAD patients

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Single or double-level anterior interbody fusion techniques for cervical degenerative disc disease

Jacobs

Willems

Limbeek³

et al. 2011

Cochrane Database of Systematic Reviews

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Background The number of surgical techniques for decompression and solid interbody fusion as treatment for cervical spondylosis has increased rapidly, but the rationale for the choice between different techniques remains unclear. Objectives To determine which technique of anterior interbody fusion gives the best clinical and radiological outcomes in patients with single-or double-level degenerative disc disease of the cervical spine.

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Long-term randomised comparison between a carbon fibre cage and the Cloward procedure in the cervical spine

Cited by 55 publications

References 29 publications

A Comparison Between the Carbon Fiber Cage and the Cloward Procedure in Cervical Spine Surgery

A Comparison Between the Carbon Fiber Cage and the Cloward Procedure in Cervical Spine Surgery

Function in Patients With Cervical Radiculopathy or Chronic Whiplash-Associated Disorders Compared With Healthy Volunteers

Single or double-level anterior interbody fusion techniques for cervical degenerative disc disease

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