Radiographic Comparison of Four Anterior Fusion Methods in Two Level Cervical Disc Diseases : Autograft Plate Fixation versus Cage Plate Fixation versus Stand-Alone Cage Fusion versus Corpectomy and Plate Fixation

Abstract

ObjectiveTo evaluate radiographic results of anterior fusion methods in two-level cervical disc disease : tricortical autograft and plate fixation (ACDF-AP), cage and plate fixation (ACDF-CP), stand-alone cage (ACDF-CA), and corpectomy and plate fixation (ACCF).MethodsThe numbers of patients were 70 with a minimum 6 month follow-up (ACDF-AP : 12, ACDF-CP : 27, ACDF-CA : 15, and ACCF : 16). Dynamic simple X-ray and computed tomography were evaluated preoperatively, postoperatively, 6 month, and at the final follow-up. The fusion and subsidence rates at the final were determined, and global cervical lordosis (GCL), cervical range of motion, fused segment angle (FSA), and fused segment height (FSH) were analyzed.ResultsNonunion was observed in 4 (25%) patients with ACDF-CA, 1 (8%) patient with ACDF-AP, 1 (4%) patient with ACDF-CP. The number of loss of FSH (%) more than 3 mm were 2 patients (16%) in ACDF-AP, 3 patients (11%) in ACDF-CP, 5 patients (33%) in ACDF-CA, and 3 patients (20%) in ACCF. The GCL was decreased with ACDF-CA and increased with others. The FSA was increased with ACDF-AP, ACDF-CP, and ACCF, but ACDF-CA was decreased. At the final follow-up, the FSH was slightly decreased in ACDF-CP, ACDF-AP, and ACCF, but ACDF-CA was more decreased. Graft related complication were minimal. Screw loosening, plate fracture, cage subsidence and migration were not identified.ConclusionACDF-CP demonstrated a higher fusion rate and less minimal FSH loss than the other fusions in two-level cervical disc disease. The ACDF-AP and ACCF methods had a better outcome than the ACDF-CA with respect to GCL, FSA, and FSH.

The influence of cervical plate fixation with either autologous bone or cage insertion on radiographic and patient-rated outcomes after two-level anterior cervical discectomy and fusion

“…These findings are in accordance with the conclusions of previously published studies. [19,20] Although we found no significant effect of surgical technique per se on clinical outcome, a greater change in segmental height preoperatively to LFU was associated with a significantly better GTO and a trend for a greater reduction (i.e. improvement) in the COMI score.…”

Autologous bone graft versus PEKK cage for vertebral replacement after 1- or 2-level anterior median corpectomy

“…There was 1 patient with significant donor-site morbidity (fracture of the iliac crest) that required iliac osteosynthesis. Avoiding donor-site morbidity is the most striking argument for the use of artificial implants, 1,7 and this case in our series also illustrates the problem. Donor-site morbidity may include pain, hematoma, fracture, or meralgia paresthetica and has been reported to occur in up to 25% of patients.…”

Осложнения Вентральной Межтеловой Фиксации Шейных Позвонков Динамическими Пластинами

“…3 Рентгенограммы, демонстрирующие миграцию ротационной пластины и винтов (а), миграцию пластины и костного кортикально-губчатого трансплантата, выкру-чивание винтов (стрелки) (б) б а 3/2014 (С. [22][23][24][25][26][27][28][29][30][31] Повреждения позвоночника ХИРУРГИЯ ПОЗВОНОЧНИКА А.Е. Барыш, С.А.…”

“…Оседание более 3 мм наблюдали при спондило-дезе с использованием динамических пластин и костных кортикально-губ-чатых аутотрансплантатов у 2 (16 %) больных, с применением динамиче-ских пластин и вертикальных цилин-дрических сетчатых имплантатов -у 3 (11 %) пациентов, в 3 (20 %) слу-чаях при выполнении корпэктомии и спондилодеза с помощью динамиче-ских пластин и костных кортикально-губчатых аутотрансплантатов. Авто-ры пришли к выводу, что наилучшей методикой при лечении заболеваний ШОП на двух смежных уровнях явля-ются дискэктомия и передний межте-ловой спондилодез с помощью дина-мических пластин, вертикального цилиндрического сетчатого импланта-та или кейджа [24]. Другие авторы [44] изучали результаты лечения 10 паци-ентов с травмами и заболеваниями ШОП с использованием телескопи-ческих кейджей и трансляционных динамических пластин, в 4 случаях дополнительно выполняли задний спондилодез.…”

“…[42]. Некоторые исследователи в своих публикациях продемонстрировали преимущества динамических пластин перед ригид-ными, выражающиеся в оптимиза-ции процесса межтелового сращения и уменьшении количества осложне-ний [24,30,36,37,44].…”