Single anterior cervical discectomy and fusion (ACDF) using self- locking stand-alone polyetheretherketone (PEEK) cage: evaluation of pain and health-related quality of life

Abstract

Background: Anterior cervical discectomy and fusion (ACDF) constitutes the conventional treatment of cervical disc herniation due to degenerative disc disease (DDD). ACDF with plating presents a variety of complications postoperatively and stand-alone cages are thought to be a promising alternative. The aim of this study was firstly, to analyze prospectively collected data from a sample of patients treated with single ACDF using C-Plus self-locking stand-alone PEEK cage system, without the use of plates or screws, in order to evaluate pain levels of patients, utilizing Neck and Arm Pain scale as an expression of visual analogue scale (VAS). Secondly, we aimed to evaluate health-related quality of life, via the short-form 36 (SF-36) and Neck Disability Index (NDI).Methods: Thirty-six patients (19 male and 17 female) with mean age 49.6±7 years old who underwent successful single ACDF using self-locking stand-alone PEEK cage for symptomatic cervical DDD were selected for the study. Neck and Arm pain, as well as SF-36 and NDI were estimated preoperatively and 1, 3, 6, and 12 months postoperatively. Patients underwent preoperative and postoperative clinical, neurological and radiological evaluation. Results:The clinical and radiological outcomes were satisfactory after a minimum 1-year follow-up.All results were statistically important (P<0.05), excluding improvement in NDI measured between 6 and 12 months. SF-36, Neck Pain, as well as Arm Pain featured gradual and constant improvement during follow-up, with best scores presenting at 12 months after surgery, while NDI reached its best at 6 months postoperatively.Conclusions: Generally, all scores showed improvement postoperatively during the different phases of the follow-up. Subsequently, ACDF using C-Plus cervical cage constitutes an effective method for cervical disc herniation treatment, in terms of postoperative improvement on pain levels and health-related quality of life and a safe alternative to the conventional method of treatment for cervical DDD.

Single Level ACCF Combining Single Level Stand-alone ACDF in Treating Cervical Spondylotic Myelopathy

“…Lu's research showed that in treating two level CSM, ACDF with stand-alone cage is associated with greater postoperative disc height and reduced chances of cervical lordosis 10 . Kapetanakis also proved that single level ACDF using stand-alone cage could significantly improve patients' life qualities 11 .…”

“…The average JOA Scores of the AcAsa group 1 day, 6 months and 12months postoperatively were 12.57 ± 1.87 (6-16, 13), 13.10 ± 1.71 (8-16, 14) and 13.58 ± 1.69(8)(9)(10)(11)(12)(13)(14)(15)(16) 14). The corresponding improvement rates of JOA Score (RIS) were 21.63%±24.35% (-66.67%-75%, 25.00%), 30.14% ±24.31% (-66.67%-75%, 33.33%) and 39.68 ± 24.17 (-33.33%-83.33%, 42.86%).…”

Psychological predictors of quality of life after anterior cervical discectomy and fusion for degenerative cervical spine disease

“…Despite the existence of numerous studies documenting QOL and functional outcomes after ACDF and a growing body of literature examining psychological scores in the context of lumbar spine surgery, there is considerably less evidence for the correlation between anxiety as well as depression and QOL outcomes after ACDF [13][14][15][16][17][18]39,[52][53][54][55][56][57] .…”

The outcomes of stand alone polyetheretherketone cages in anterior cervical discectomy and fusion

“…One study defined fusion as the occurrence of anterior and posterior bone bridges on radiographs [21]. Park et al [24], Farrokhi et al [12], and Kapetanakis et al [22] defined fusion by the presence of motion and bone bridging on radiographs. Suess et al [18] defined fusion with three parameters consisting of bony bridging, absence of radiolucency at the implant-vertebrae interface, and the lack of motion on dynamic x-rays.…”

“…The subsidence rate was evaluated vaguely by radiographs in three studies [14,16,23]. Three studies defined subsidence as the radiographic change of at least 3 mm in the interbody space [13,17,24,25], whereas another two studies considered subsidence as a change of at least 2 mm in the interbody distance [21,22]. Kim et al [20] defined subsidence as a decrease of interbody height by more than 2.5 mm on lateral radiographs.…”