Three-level anterior cervical discectomy and fusion with self-locking stand-alone polyetheretherketone cages

Zhou, Jian; Li, Xilei; Dong, Jian; Zhao, Xiaogang; Fang, Taolin; Lin, Hong; Ma, Yiqun

doi:10.1016/j.jocn.2011.02.045

Cited by 45 publications

(37 citation statements)

References 26 publications

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“…Biomechanical studies have revealed that the self-locking stand-alone cage provides less stiffness of cervical spine as locking plate does in 2 or 3-level instrumentation [14,15]. But high fusion rate can be achieved using these kinds of cages for the treatment of single-level, double-level, and even three-level cervical spondylopathy (Table 3) [7][8][9][10][16][17][18]. In our study, the nonunion rate was not statistically significant between groups [4.3 % (4/28) vs 7.7 % (2/26)] (P = 0.736).…”

Section: Discussionmentioning

confidence: 99%

“…Studies have also shown that this kind of cages can effectively restore cervical lordosis, and obviate the platerelated complications, as compared to ACDF using cages and plate fixation for single or double-level cervical spondylopathy [7][8][9]. Further, a non-comparative study has reported satisfactory clinical efficacy and radiological outcomes with the three-level ACDF using this kind of PEEK cages [10]. The objective of this study was to evaluate the clinical and radiological outcomes of ACDF using self-locking stand-alone PEEK cages for treatment of three-level cervical spondylopathy compared with ACDF using cages with plate fixation.…”

Section: Introductionmentioning

confidence: 90%

“…Nonunion means the presence of more than 2°range of motion on flexion-extension lateral radiographs or the presence of a radiolucent gap between the graft and the end plate on radiographs or CT scans in at least one operated level at the last follow-up [10]. The other radiological outcomes were measured pre-operatively and at 2 weeks, 3, 6, 12 and 24 months post-operatively.…”

Section: Radiological Outcomesmentioning

confidence: 99%

See 2 more Smart Citations

A comparison of anterior cervical discectomy and fusion (ACDF) using self-locking stand-alone polyetheretherketone (PEEK) cage with ACDF using cage and plate in the treatment of three-level cervical degenerative spondylopathy: a retrospective study with 2-year follow-up

et al. 2016

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ACDF using self-locking stand-alone cages showed similar clinical results as compared to ACDF using cages and plate fixation for the treatment of three-level cervical degenerative spondylopathy. However, potential long-term problems such as cage subsidence, loss of cervical lordosis and fused segment angle post-operatively were shown to be associated with patients who underwent ACDF using self-locking stand-alone cages.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 90%

Section: Radiological Outcomesmentioning

confidence: 99%

See 1 more Smart Citation

A comparison of anterior cervical discectomy and fusion (ACDF) using self-locking stand-alone polyetheretherketone (PEEK) cage with ACDF using cage and plate in the treatment of three-level cervical degenerative spondylopathy: a retrospective study with 2-year follow-up

et al. 2016

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“…This cage has anti-migration teeth which are considered to be similar to a plate and screws, offering immediate stabilization. Studies have also shown that these cages can effectively restore cervical lordosis, and reduce plate-related complications (26).…”

Section: Introductionmentioning

confidence: 99%

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

Kapetanakis¹,

Thomaidis²,

Charitoudis³

et al. 2017

J. Spine Surg.

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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.

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“…Management of multilevel cervical spondylosis via anterior approach is scarcely and incompletely documented, so literature lacks in reporting ACDF without the use of plates or autogenous bone grafts. As the outcomes of 2-level and 3-level surgeries have been published declaring good results with less complications including subsidence, migration, structural failure and non union, surgeons are encouraged to perform 3-to 4-level ACDF solely with PEEK cages without further stabilization in cervical spondylosis [10,11]. In the past, though non-instrumented ACDF raised much concern for a while, reports about the long-term performance and outcome have not been affirmative.…”

Section: Introductionmentioning

confidence: 99%

Anterior cervical discectomy and fusion solely with peek cages in multilevel cervical spondylotic radiculomyelopathy: single center clinical experience with 58 consecutive patients

Şimşek¹

2017

Med-Science

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Aim of this study was to evaluate the efficacy and safety of fusion solely with polyetheretherketone (PEEK) cages without plates and autogenous bone graft to provide fusion in multilevel cervical spondylosis in selected cases. 58 patients with cervical discogenic disorders in 3-4 levels (38 and 20 patients respectively) underwent multilevel anterior cervical discectomy and fusion (ACDF) operations with PEEK cages for a total of 194 levels. Minimum follow up was 24 months (24-48) postoperatively. Outcome had been established in combination with the evaluation of cervical lordosis, fusion rates and neurological improvement that was assessed by Japanese Orthopedic Association (JOA) scoring system. They were assessed by radiographs, computerized tomography and magnetic resonance imaging studies. Clinical outcomes were based on the issues including length of hospital stay, blood loss, complication rates and functional outcomes. 38 patients underwent three-level, 20 patients underwent four-level operations. Fusion rate was 89.2%. Significant improvement in the JOA scores was recorded postoperatively, and Ishihara Curvature Index (ICI) was preserved. In the follow-up period, no cage migration was experienced and reoperation was not required except for one who later underwent corpectomy and anterior fusion. ACDF with the use of PEEK cages without plates proved to yield good clinical outcome and comfortable postoperative course for the patients with acceptable fusion rates.

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Three-level anterior cervical discectomy and fusion with self-locking stand-alone polyetheretherketone cages

Cited by 45 publications

References 26 publications

A comparison of anterior cervical discectomy and fusion (ACDF) using self-locking stand-alone polyetheretherketone (PEEK) cage with ACDF using cage and plate in the treatment of three-level cervical degenerative spondylopathy: a retrospective study with 2-year follow-up

A comparison of anterior cervical discectomy and fusion (ACDF) using self-locking stand-alone polyetheretherketone (PEEK) cage with ACDF using cage and plate in the treatment of three-level cervical degenerative spondylopathy: a retrospective study with 2-year follow-up

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

Anterior cervical discectomy and fusion solely with peek cages in multilevel cervical spondylotic radiculomyelopathy: single center clinical experience with 58 consecutive patients

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