Cervical Disk Substitute Mixed With Cage Fusion for the Therapy of Multilevel Cervical Disk Herniation.
Clin Backbone Surg. 2016 Jul;29(6):218-25
Authors: Ren X, Chu T, Jiang T, Wang W, Wang J, Li C, Zhang Z
STUDY DESIGN: This can be a potential examine of synthetic disk alternative mixed with cage fusion for the remedy of multilevel cervical disk herniation.
OBJECTIVE: To judge the scientific end result of Bryan cervical disk alternative mixed with adjoining section cage fusion within the remedy of sufferers with multilevel cervical disk herniation. To watch neurological enchancment and interpret the radiographic findings.
SUMMARY OF BACKGROUND DATA: It’s typically thought-about that 1-level cervical disk alternative had a wonderful intermediate scientific end result. There was no ultimate conclusion concerning the disk alternative for the remedy of multilevel cervical disk illness. The unfavourable components embody doable complication, excessive value, and contraindication for disk alternative at one of many multisegments. Disk alternative mixed with adjoining section cage fusion could also be an possibility for the remedy of multilevel cervical disk illness for sure sufferers.
METHODS: There have been 26 sufferers with multilevel cervical disk herniation who underwent 1-level disk alternative and adjoining section cage fusion. Of the sufferers, there have been 17 male and 9 feminine, aged between 35 and 63 (imply age 47 y). The herniated disk was situated at C3-C4, C4-C5 in 1 case, C4-C5, C5-C6 in 11instances, C5-C6, C6-C7 in 7 instances, C4-C5, C6-C7 in three instances, and C4-C5, C5-C6, C6-C7 in four instances. There have been 12 instances with myelopathy and 14 sufferers with radiculopathy. The stabilization and the vary of movement of implanted disk, the fusion of cage, and the displacement of cage had been noticed on dynamic radiograph postoperatively. The scientific signs and the neurological features had been evaluated based mostly on the Japanese Orthopaedic Affiliation Scale rating (17 factors), neck incapacity index rating, and Odom’s Standards.
RESULTS: All sufferers underwent 1-level Bryan disk alternative and cage fusion on adjoining section. The alternative section and fusion section had been situated subsequent to one another amongst 23 sufferers. They weren’t subsequent to one another in three instances. The follow-up was 24 to 47 months. Particular stabilization was achieved for all Bryan disks. The common vary of movement at changed stage was 9.5 levels postoperatively. Strong fusion was achieved in all cages. There was no subsidence or displacement of cage. The Japanese Orthopaedic Affiliation Scale rating (17 factors) rose from 9.2 to 13.5 at ultimate follow-up. The neck incapacity index was diminished from 40.eight to 28.5 at ultimate follow-up. The scientific success (wonderful/good/honest) based mostly on Odom’s Standards had been 84.6%.
CONCLUSIONS: Particular stabilization and passable mobility had been achieved after cervical disk alternative and cage fusion. This supplies an efficient possibility for the remedy of multilevel cervical disk herniation. The analysis of excessive fusion price of cage could have to accumulate extra scientific instances.
PMID: 22832555 [PubMed – indexed for MEDLINE]