Long term outcome and adjacent disc degeneration after anterior cervical discectomy and fusion with titanium cylindrical cages

BACKGROUND: Anterior cervical discectomy and fusion (ACDF) is widely performed for the treatment of cervical spinal degenerative disease. Autogenic or allogenic bone grafts are used for interbody fusion with satisfactory long term outcomes. However, harvest of the autograft causes donor site complications and allograft is associated with low fusion rate. Threaded titanium cages (TC) have recently been introduced to cope with these disadvantages, but there is little evidence of long term results. METHODS: The long term outcome was studied after ACDF using TC. Clinical and imaging follow up was performed in 41 patients for at least 5 years (range 5-8.3 years). New computer-assisted measurement methods for radiographs are proposed. FINDINGS: ACDF with TC achieved 80% excellent or good outcome by Odom’s criteria, 95% fusion rate, and few minor complications. Asymptomatic adjacent disc degeneration was detected in 50% of the patients by our measurement methods. However, symptomatic adjacent disc degeneration occurred in 5% of the patients and only 2% required additional surgery. CONCLUSIONS: These results are comparable or better than those after ACDF with autograft or allograft. ACDF with TC can achieve rigid fixation and provide good long term results

Keywords : Adult,adverse effects,Aged,Cervical Vertebrae,complications,diagnostic imaging,Diskectomy,epidemiology,Female,Follow-Up Studies,Humans,Image Processing,Computer-Assisted,instrumentation,Internal Fixators,Intervertebral Disc Displacement,Male,methods,Middle Aged,Neurosurgery,Outcome Assessment (Health Care),pathology,Patients,Postoperative Care,Postoperative Complications,Radiography,Radiology,Retrospective Studies,Secondary Prevention,Spinal Fusion,statistics & numerical data,surgery,therapeutic use,Time,Titanium,Treatment Outcome,, Term,Outcome,Adjacent,Disc, pars defect treatment

Date of Publication : 2009 Apr

Authors : Sugawara T;Itoh Y;Hirano Y;Higashiyama N;Mizoi K;

Organisation : Department of Neurosurgery, School of Medicine, Akita University, Akita, Japan. taku@nsg.med.akita-u.ac.jp

Journal of Publication : Acta Neurochir (Wien )

Pubmed Link : https://www.ncbi.nlm.nih.gov/pubmed/19262984

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