Outcomes of Anterior Cervical Fusion Using Polyetheretherketone Cage with Demineralized Bone Matrix and Plate for Management of Subaxial Cervical Spine Injuries

Han, Moon-Soo; Lee, Gwang-Jun; Kim, Ju-Hwi; Lee, Seul-Kee; Moon, Bong Ju; Lee, Jung-Kil

doi:10.13004/kjnt.2018.14.2.123

Cited by 7 publications

(5 citation statements)

References 35 publications

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“…In our study, the use of DBM was found to be associated with an increased swelling. However, Other studies have reported that the use of DBM is not significantly associated with the occurrence of complications, such as swelling and dysphagia [ 12 , 16 ]. This discrepancy may be attributed to the differences in sample sizes between our study and previous research.…”

Section: Discussionmentioning

confidence: 99%

Risk Factors for Prevertebral Soft Tissue Swelling Following Single-level Anterior Cervical Spine Surgery

Park,

Kang,

Won

et al. 2023

J Korean Neurosurg Soc

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Objective : Anterior cervical spine surgery (ACSS) is a common surgical procedure used to treat cervical spinal degenerative diseases. One of the complications associated with ACSS is prevertebral soft tissue swelling (PSTS), which can result in airway obstruction, dysphagia, and other adverse outcomes. This study aims to investigate the correlation between various cervical sagittal parameters and PSTS following single-level ACSS, as well as to identify independent risk factors for PSTS.Methods : A retrospective study conducted at a single institution. The study population included all patients who underwent single-level ACSS between January 2014 and December 2022. Patients with a history of cervical spine surgery or trauma were excluded from the study. The presence and severity of PSTS was assessed by reviewing pre- and postoperative imaging studies. The potential risk factors for PSTS that were examined include patient age, sex, body mass index, tobacco use, comorbidities, serum albumin levels, operative time, implant type, implanted level, and various cervical spine sagittal parameters. Multivariate linear regression analysis was performed to identify the independent risk factors for PSTS.Results : A total of 62 consecutive patients who underwent single-level ACSS over a 8-year period at a single institution were enrolled in this study. Only preoperative segmental angle showed positive correlation with PSTS among various cervical spine sagittal parameters (r=0.36, p=0.005). Artificial disc replacement showed a negative correlation with PSTS (β=-0.38, p=0.002), whereas the use of demineralized bone matrix (DBM) had a positive impact on PSTS (β=0.33, p=0.009). We found that male sex, lower preoperative serum albumin, and implantation of upper cervical level (above C5) were independent predictors for PSTS after single-level ACSS (β=1.21; 95% confidence interval [CI], 0.27 to 2.15; p=0.012; β=-1.63; 95% CI, -2.91 to -0.34; p=0.014; β=1.44; 95% CI, 0.38 to 2.49; p=0.008, respectively).Conclusion : Our study identified male sex, lower preoperative serum albumin levels, and upper cervical level involvement as independent risk factors for PSTS after single-level ACSS. These findings can help clinicians monitor high-risk patients and take preventive measures to reduce complications. Further research with larger sample sizes and prospective designs is needed to validate these findings.

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Section: Discussionmentioning

confidence: 99%

Risk Factors for Prevertebral Soft Tissue Swelling Following Single-level Anterior Cervical Spine Surgery

Park,

Kang,

Won

et al. 2023

J Korean Neurosurg Soc

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“…About 89% of the patients with preoperative radiculopathy improved and were without symptoms on follow-ups. Han et al 16 considered the follow-up 27.6 months, where one Frankel grade improvement was observed in 21 cases (21.4%). This study showed complete fusion in all of their patients.…”

Section: Discussionmentioning

confidence: 99%

The Outcome of Subaxial Cervical Injury in Adult Patients Managed Surgically Through an Anterior Approach

Kalhoro

Panezai²,

Hassan³

et al. 2021

Pak J Neurol Surg

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Objectives: We determined the Outcome of subaxial cervical injury management in adults through anterior approach open reduction and fixation injury < 72 hours. Material and Methods: A total of 71 patients declared to have a recent chronicle of traumatic cervical spine injury with a conventional diagnosis of subaxial injury by Magnetic Resonance Imaging (MRI) and X-Ray anteroposterior and lateral views. ASIA Impairment Scale was used for assessment and was done at the time of admission and after six months. Results: Mean age of the patients in our study was 38.54 ± 5.47 years. According to American Spinal Injury Association (ASIA) scale, improvement by two grades was seen in 18 cases and improvement by one – grade was observed in 48 cases. Mortality was seen in 5 cases, where 2 deaths were related to associated injury, one related to a complication of surgery and other 2 died due to aspiration complications. Out of 66 cases, the outcome was good in 49 (74.29%) and fair in 17 (25.76%). Conclusion: The study results revealed that Anterior Cervical Discectomy and Fusion (ACDF) is considered to be a better treatment choice for better anatomical stabilization of the spine with early reduction. Keywords: Subaxial cervical injury, anterior approach, ASIA (American Spinal Injury Association) scoring.

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“…The cagealone fusion of the single segment has been reported not to be inferior in the clinical progress in comparison with ACDF combining both cage or spacer and plate and screw fixation, however in the case of multiple segments, ACDF combining both cage or spacer and plate and screw fixation shows more stable clinical and radiologic results than cagealone fusion 1,6,14,39) . A plate can be used with cages or spacers made of various materials such as titanium, PEEK, and allobone and can be used by packing bone materials inside 10,32,40) . In some cases, it is used only as a spacer made in a mesh form and inserted simply.…”

Section: Discussionmentioning

confidence: 99%

“…Polyetheretherketone (PEEK) and titanium cages may be used as stand-alone for a single-level cervical disc disease, however the incidence of subsidence and non-union is high multi-level cervical disc diseases of 2 or more levels, making it difficult to expect stable bone fusion 4,12,35,38) . Therefore, rather than stand-alone cage fusion, surgery to transplant a bone substitute into interbody space by packing it in a spacer or cage and to induce stable bone fusion by reinforcing the fixation force with the plate and screw fixation in recent years 10,33,40) . Allograft cervical spacer is the most commonly used implant material and shows a relatively stable fusion rate, however various problems such as spacer breakage, subsidence, dislodgement, and non-union occur in the process of bone fusion, resulting in relatively moderate clinical results such as delayed bone fusion and axial pain, as well as serious severe complications such as re-operation 25,31,41) .…”

Section: Introductionmentioning

confidence: 99%

Bioactive Glass-Ceramic (NOVOMAX®) Spacer for Anterior Cervical Discectomy and Fusion: A Minimum 2-Year Follow-Up Study

Kim

Cho

Kwack

et al. 2020

Nerve

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This was a prospective study to compare anterior cervical discectomy and fusion (ACDF) using a synthetic bioactive glass-ceramic spacer (NOVOMAX ® ) and allograft spacer by evaluating the clinical and radiologic results. Methods: In total, 51 patients were prospectively enrolled with cervical degenerative disc disease who requiring ACDF. Seventeen patients were enrolled who underwent ACDF with NOVOMAX ® spacer (Group 2) study group, and 34 patients were enrolled who underwent ACDF with allograft spacer (Group 1). Both groups were fixed with a cervical locking plate. Plain X-ray and computed tomographic scans were performed 12 and 24 months later after surgery to evaluate the status of bone fusion. Clinical outcome was assessed using the neck disability index (NDI) and the Visual analogue scale (VAS). Results: The 32 levels (100%) in Group 2 and 46 levels (97.8%) in Group 1 were confirmed as fused at 24 months. There was no significant difference between the fusion rates observed in both groups (p=0.82). In Group 1, allograft spacer related complications occurred in 34 cases (74%), whereas in 6 cases in Group 2 (19%). There was no significant difference in NDI, or VAS scores at 24 months follow-up. Conclusion: ACDF using NOVOMAX ® spacer well maintains the height of the intervertebral space of the operative segment as well as the decompression of neural structure and is recommended as surgical treatment of safe and efficient degenerative cervical disc disease which can expect stable radiological results.

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Outcomes of Anterior Cervical Fusion Using Polyetheretherketone Cage with Demineralized Bone Matrix and Plate for Management of Subaxial Cervical Spine Injuries

Cited by 7 publications

References 35 publications

Risk Factors for Prevertebral Soft Tissue Swelling Following Single-level Anterior Cervical Spine Surgery

Risk Factors for Prevertebral Soft Tissue Swelling Following Single-level Anterior Cervical Spine Surgery

The Outcome of Subaxial Cervical Injury in Adult Patients Managed Surgically Through an Anterior Approach

Bioactive Glass-Ceramic (NOVOMAX<sup>®</sup>) Spacer for Anterior Cervical Discectomy and Fusion: A Minimum 2-Year Follow-Up Study

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