Long-Term Results After Anterior Cervical Fusion and Osteosynthetic Stabilization for Fractures and/or Dislocations of the Cervical Spine

Goffin, Jan; Loon, Johan van; Calenbergh, Frank Van; Plets, Chris

doi:10.1097/00002517-199512000-00014

Cited by 217 publications

(112 citation statements)

References 0 publications

Supporting

Mentioning

100

Contrasting

Unclassified

Order By: Relevance

“…In the trauma setting most surgeons use tricortical iliac crest grafts [3,10,11,21,40,41,47,52,55,59,77,82,85,89,95] and the time to union is reported with 3-4 months [3,21,82,95] reflecting observations in the current series. Stulik et al [89] reported a fusion-rate of 99% in 68 patients after ACDFP and Kandiziora et al [56] reported a fusion rate of 96% in 56 patients using either a TMC or iliac crest graft with ACDFP.…”

Section: Fusion Ratesupporting

confidence: 59%

“…In two series of Blauth with ACDFP for subaxial injuries in 79 [11] and 87 patients [10], asymptomatic adjacent-level anterior ossifications were seen in 47.3 and 51.8%, respectively. Goffin et al [41] reported on adjacent-level degenerative changes in 60% of patients that had ACDFP, again without causing symptoms. Significant factors related to ASD were multilevel fusion, lower cervical segment fusion and Frankel A-C patients.…”

Section: Adjacent-segment Degenerationmentioning

confidence: 99%

“…Nevertheless, although ACDFP was suggested to confer excellent immediate stability making any posterior element instability clinically insignificant [85], early changes in construct geometry and mechanical failures occur and promote a debate regarding the use of anterior, posterior or combined stabilization for patients with marked instability [29]. Using ACDFP, the incidence of loss of alignment has been reported as 13-19% [47, 54], the need for supplemental posterior stabilization as 10-21% [20,92] and revision rates average of 6.5% [10,11,20,40,41,47,51,55,59,77,82,85,95]. Early plate designs relying on NC-plate-screw interfaces were suggested to be plagued by increased mechanical failure, screw loosening and pseudoarthrosis [10,11,30,40,69,77,82,85] most notably in multilevel constructs [60].…”

Section: Reconstruction and Maintenance Of Sagittal Alignmentmentioning

confidence: 99%

See 2 more Smart Citations

Mid- to long-term outcome of instrumented anterior cervical fusion for subaxial injuries

et al. 2009

View full text Add to dashboard Cite

The management of patients with subaxial cervical injuries lacks consensus, particularly in regard to the decision which surgical approach or combination of approaches to use and which approach yields the best clinical outcome in the distinct injury. The trauma literature is replete with reports of surgical techniques, complications and gross outcome assessment in heterogeneous samples. However, data on functional and clinical outcome using validated outcome measures are scanty. Therefore, the authors performed a study on plated anterior cervical decompression and fusion for unstable subaxial injuries with focus on clinical outcome. For the purpose of a strongly homogenous subgroup of patients with subaxial injuries without spinal cord injuries, robust criteria were applied that were fulfilled by 28 patients out of an original series of 131 subaxial injuries. Twenty-six patients subjected to 1-and 2-level fusions without having spinal cord injury could be surveyed after a mean of 5.5 years (range 16-128 months). The cervical spine injury severity score averaged 9.6. Cross-sectional outcome assessment included validated outcome measures (Neck pain disability index, Cervical Spine Outcome Questionnaire, SF-36), the investigation of construct failure and successful surgical outcome were defined by strict criteria, the reconstruction and maintenance of local and total cervical lordosis, adjacent-segment degeneration and intervertebral motion, and the fusion-rate using an interobserver assessment. Selfrated clinical outcome was excellent or good in 81% of patients and moderate or poor in 19% that corresponded to the results of the validated outcome measures. Results of the NPDI averaged 12.4 ± 12.7% (0-40). With the SF-36 mean physical and mental component summary scores were 47.0 ± 9.8 (18.2-59.3) and 52.2 ± 12.4 (14.6-75.3), respectively. Using merely non-constrained plates, construct failure was observed in 31% of cases and loss of local lordosis, expressed as a mean injury angle of 14°, postoperative angle of -5.5°and follow-up angle of -1°, was significant. However, total cervical lordosis was within the limits of normalcy (-24.3°± 13.3) and fusion-rate was 88.5%. The progression of adjacent-level degeneration was shown to be significantly influenced by a decreased plate-to-disc-distance. Adjacent-level intervertebral motion was not altered due to the adjacent fusion, but reduced in Electronic supplementary material The online version of this article

show abstract

Section: Fusion Ratesupporting

confidence: 59%

Section: Adjacent-segment Degenerationmentioning

confidence: 99%

Section: Reconstruction and Maintenance Of Sagittal Alignmentmentioning

confidence: 99%

See 1 more Smart Citation

Mid- to long-term outcome of instrumented anterior cervical fusion for subaxial injuries

et al. 2009

View full text Add to dashboard Cite

show abstract

“…11 The prevalence of RASP in the trauma cohort studied by Jack et al was only 1/32 (3.1%). This is remarkably low compared with other published trauma cohorts, which range from 5.2% at 2.5 years 8 to 60.0% at 7 years, 10 but may be at least partially explained by the fact that radiologic follow-up was only 13 months. 3 Jack et al 3 compared a trauma cohort to a degenerative cohort at their center, thus hopefully eliminating many of the problems with between-study comparisons.…”

contrasting

confidence: 60%

Adjacent Segment Pathology: Much to Do About How Much Is Due to What We Do

Fourney

2016

Can. J. Neurol. Sci.

View full text Add to dashboard Cite

“…Fusion does accelerate radiological and clinical adjacent segment disease in the long-term as younger patients with fusion operated for traumatic spine injury seem to have these changes earlier [31]. Conversely, cervical arthroplasty that has the potential advantage of retaining cervical motion and perhaps decreasing the incidence of adjacent-segment degeneration, has not been proved to be superior to anterior cervical discoidectomy with fusion in the short-term, however, the need for revision surgery following arthroplasty is reported to be less than after fusion procedures [32].…”

Section: Motion Preservation or Fusionmentioning

confidence: 99%

Reduction in range of cervical motion on serial long-term follow-up in patients undergoing oblique corpectomy for cervical spondylotic myelopathy

et al. 2013

View full text Add to dashboard Cite

Purpose To determine whether motion preservation following oblique cervical corpectomy (OCC) for cervical spondylotic myelopathy (CSM) persists with serial followup. Methods We included 28 patients with preoperative and at least two serial follow-up neutral and dynamic cervical spine radiographs who underwent OCC for CSM. Patients with an ossified posterior longitudinal ligament (OPLL) were excluded. Changes in sagittal curvature, segmental and whole spine range of motion (ROM) were measured. Nathan's system graded anterior osteophyte formation. Neurological function was measured by Nurick's grade and modified Japanese Orthopedic Association (JOA) scores. ResultsThe majority (23 patients) had a single or 2-level corpectomy. The average duration of follow-up was 45 months. The Nurick's grade and the JOA scores showed statistically significant improvements after surgery (p \ 0.001). 17 % of patients with preoperative lordotic spines had a loss of lordosis at last follow-up, but with no clinical worsening. 77 % of the whole spine ROM and 62 % of segmental ROM was preserved at last follow-up. The whole spine and segmental ROM decreased by 11.2°a nd 10.9°, respectively (p B 0.001). Patients with a greater range of segmental movement preoperatively had a statistically greater range of movement at follow-up. The analysis of serial radiographs indicated that the range of movement of the whole spine and the range of movement at the segmental spine levels significantly reduced during the follow-up period. Nathan's grade showed increase in osteophytosis in more than two-thirds of the patients (p B 0.01). The whole spine range of movement at followup significantly correlated with Nathan's grade. Conclusions Although the OCC preserves segmental and whole spine ROM, serial measurements show a progressive decrease in ROM albeit without clinical worsening. The reduction in this ROM is probably related to degenerative ossification of spinal ligaments.

show abstract

Long-Term Results After Anterior Cervical Fusion and Osteosynthetic Stabilization for Fractures and/or Dislocations of the Cervical Spine

Cited by 217 publications

References 0 publications

Mid- to long-term outcome of instrumented anterior cervical fusion for subaxial injuries

Mid- to long-term outcome of instrumented anterior cervical fusion for subaxial injuries

Adjacent Segment Pathology: Much to Do About How Much Is Due to What We Do

Reduction in range of cervical motion on serial long-term follow-up in patients undergoing oblique corpectomy for cervical spondylotic myelopathy

Contact Info

Product

Resources

About