The Choice of the Best Surgery After Single Level Anterior Cervical Spine Discectomy: A Systematic Review

Botelho, Ricardo Vieira; Buscariolli, Yuri dos Santos; Serra, Marcus Vinicius Flores de Barros Vasconcelos Fernandes; Bellini, Marcia Nogueira Pires; Bernardo, Wanderley Marques

doi:10.2174/1874325001206010121

Cited by 16 publications

(8 citation statements)

References 15 publications

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“…As is the case with many other grafts, which are currently used in spine surgery, there are no studies with an evidence level 1 to assess the deployability of PMMA. Thus, even the widely accepted opinion on PM-MA's lesser capacity to produce fusion lacks profound evidence 52 . There is even less evidence that fused patients have a better clinical outcome than non-fused patients.…”

Section: Discussionmentioning

confidence: 99%

The use of polymethylmethacrylate in cervical spine surgery

Topalovic¹,

Kroppenstedt²,

Čabraja³

2013

Hard Tissue

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Introduction The use of polymethylmethacrylate (PMMA) after anterior cervical discectomy (ACD) shows high rates of graft migration and pseudarthrosis when compared with various other fusion procedures. Due to this fact, it is currently not considered the preferred choice of treatment in many countries. This review discusses the use of PMMA in cervical spine surgery. Materials and methods A literature review was conducted, and the articles were assessed for level of bias using the criteria recommended by the Cochrane Back Review Group. Results During last 30 years, five prospective and seven retrospective studies have been published that investigate PMMA-assisted ACD. While the radiological analysis shows inferior radiological results, the clinical outcome is not affected adversely by the intervertebral insertion of PMMA when compared with other r eplacement substrates. Conclusion Since there is no evidence that fusion is mandatory for clinical success, and no study has showed an inferior clinical outcome of PMMAassisted ACD in comparison with other substrates, PMMA can be used successfully in cervical spine surgery. Furthermore, the level of bias of the published studies supports the need of a controlled randomized multicentre trial. Only if fusion is mandatory for clinical success in certain cases, alternative grafts should be preferred since PMMA produces inferior radiological outcomes compared to cages or bone grafts.

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Section: Discussionmentioning

confidence: 99%

The use of polymethylmethacrylate in cervical spine surgery

Topalovic¹,

Kroppenstedt²,

Čabraja³

2013

Hard Tissue

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“…Kim et al analysed the whole spine sagittal alignment after ACDF and concluded that the fusion procedure affects the spine sagittal alignment: cervical lordosis decreased especially in patients with high cervical lordosis and the sagittal vertical axis decreased [17] .…”

Section: Discussionmentioning

confidence: 99%

Anterior Cervical Discectomy with or without Fusion in Non-traumatic Single level Cervical Disc Disorder: Study of 50 Cases

Das

Rashid²,

Zahan

et al. 2018

J Dhaka Med Coll

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Objectives: The aim of this study is to compare patients undergoing single level anterior cervical discectomy without fusion (ACD) versus anterior cervical discectomy with fusion (ACDF). Methods: A retrospective analysis of 50 patients with degenerative cervical spondylosis of them 25 had undergone ACD without fusion and remaining 25 undergone ACDF at either C4-C5, C5- C6 level or at C6-C7 level. Results: The kinematic analysis included the range of motion, intervertebral angulations, anteroposterior translation and disc height assessed for the cervical functional spinal units at the operated level and adjacent levels. At the operated level of C4-C5, C5-C6 and C6-C7, the range of motion and the translation were minimal in the anterior cervical discectomy without fusion (ACD) group, but absent in the cervical discectomy with fusion (ACDF) group. The superior adjacent levels range of motion and the translation were greater in the ACDF group compared with the ACD group. But both groups had almost similar results in term of hospital stay, mean time for improvement and patient satisfaction. Conclusion: The clinical results of anterior cervical discectomy without fusion (ACD) and anterior cervical discectomy with fusion (ACDF) were comparable. In cervical discectomy without fusion, the elastic fibrous intradiscal scar at the operated level allows a small degree of mobility and the adjacent cervical levels are not overstressed. Fusion is not routinely required in single level cervical disc herniation until it is associated with instability, loss of cervical lordosis, hard disc, osteophytic bar and multi-segmental disease. So ACD is a better option in single level cervical disc disorder than ACDF. J Dhaka Medical College, Vol. 27, No.1, April, 2018, Page 29-35

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“…Central canal compromise that cannot be reached through a posterior keyhole foraminotomy can be more safely addressed with anterior revision of the ACDF or posterior laminectomy for multiple level pathology. 8,18,32,41 More aggressive attempts at resecting medially located disc material are associated with higher morbidity. 34 We have also found that recurrent radiculopathy due to disc disease at the index level is more commonly a residual stenosis rather than a true disc recurrence, which was more common at fresh level.…”

Section: Discussionmentioning

confidence: 99%