Stand-Alone Cervical Cages in 2-Level Anterior Interbody Fusion in Cervical Spondylotic Myelopathy: Results from a Minimum 2-Year Follow-up
Study Design A retrospective review of patients who underwent 2-level anterior cervical discectomy and fusion (ACDF) with standalone polyetheretherketone (PEEK) cages for cervical spondylotic myelopathy (CSM). Purpose To evaluate the efficacy of stand-alone PEEK cage in 2-level cervical interbody fu...
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Format: | Article |
Language: | English |
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Korean Spine Society
2019-04-01
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Series: | Asian Spine Journal |
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Online Access: | http://www.asianspinejournal.org/upload/pdf/asj-2018-0193.pdf |
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author | Eugene Pak-Lin Ng Andrew Siu-Leung Yip Keith Hay-Man Wan Michael Siu-Hei Tse Kam-Kwong Wong Tik-Koon Kwok Wing-Cheung Wong |
author_facet | Eugene Pak-Lin Ng Andrew Siu-Leung Yip Keith Hay-Man Wan Michael Siu-Hei Tse Kam-Kwong Wong Tik-Koon Kwok Wing-Cheung Wong |
author_sort | Eugene Pak-Lin Ng |
collection | DOAJ |
description | Study Design A retrospective review of patients who underwent 2-level anterior cervical discectomy and fusion (ACDF) with standalone polyetheretherketone (PEEK) cages for cervical spondylotic myelopathy (CSM). Purpose To evaluate the efficacy of stand-alone PEEK cage in 2-level cervical interbody fusion for CSM. Overview of Literature ACDF is a standard surgical procedure to treat degenerative disc disease. However, the use of additional anterior plating for 2-level ACDF remains controversial. Methods We reviewed outcomes of patients who underwent 2-level ACDF with stand-alone PEEK cages for CSM over a 7-year period (2007–2015) in a regional hospital. Japanese Orthopaedic Association (JOA) score, fusion rate, subsidence rate, cage migration, and cervical alignment by the C2–7 angle as well as the local segmental angle (LSA) of the cervical spine were assessed. Results In total, 31 patients (mean age, 59 years; range, 36–87 years) underwent 2-level ACDF with a cage-only construct procedure between 2007 and 2015. The minimum follow-up was 24 months; mean follow-up was 51 months. C3–5 fusion was performed in 45%, C4–6 fusion in 32%, and C5–7 fusion in 23%. Mean JOA score improved from 10.1±2.2 to 13.9±2.1 (p<0.01) at the 24-month follow-up. Fusion was achieved in all patients. Subsidence occurred in 22.5% of the cages but was not associated with differences in JOA scores, age, sex, or levels fused. Lordosis of the C2–7 angle and LSA increased after surgery, which were maintained for up to 1 year but subsequently disappeared after 2 years, yet the difference was not statistically significant. No cage migration was noted; two patients developed adjacent segment disease requiring posterior laminoplasty 3 years after ACDF. Conclusions The use of a stand-alone PEEK cage in a 2-level cervical interbody fusion achieves satisfactory improvements in both clinical outcomes and fusion. |
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format | Article |
id | doaj.art-d580ab478ac24e929d38c698678a4388 |
institution | Directory Open Access Journal |
issn | 1976-1902 1976-7846 |
language | English |
last_indexed | 2024-12-10T06:17:35Z |
publishDate | 2019-04-01 |
publisher | Korean Spine Society |
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series | Asian Spine Journal |
spelling | doaj.art-d580ab478ac24e929d38c698678a43882022-12-22T01:59:24ZengKorean Spine SocietyAsian Spine Journal1976-19021976-78462019-04-0113222523210.31616/asj.2018.01931004Stand-Alone Cervical Cages in 2-Level Anterior Interbody Fusion in Cervical Spondylotic Myelopathy: Results from a Minimum 2-Year Follow-upEugene Pak-Lin NgAndrew Siu-Leung Yip0Keith Hay-Man Wan1Michael Siu-Hei Tse2Kam-Kwong Wong3Tik-Koon Kwok4Wing-Cheung Wong5 Department of Orthopaedics and Traumatology, Kwong Wah Hospital, Hong Kong Department of Orthopaedics and Traumatology, Kwong Wah Hospital, Hong Kong Department of Orthopaedics and Traumatology, Kwong Wah Hospital, Hong Kong Department of Orthopaedics and Traumatology, Kwong Wah Hospital, Hong Kong Department of Orthopaedics and Traumatology, Kwong Wah Hospital, Hong Kong Department of Orthopaedics and Traumatology, Kwong Wah Hospital, Hong KongStudy Design A retrospective review of patients who underwent 2-level anterior cervical discectomy and fusion (ACDF) with standalone polyetheretherketone (PEEK) cages for cervical spondylotic myelopathy (CSM). Purpose To evaluate the efficacy of stand-alone PEEK cage in 2-level cervical interbody fusion for CSM. Overview of Literature ACDF is a standard surgical procedure to treat degenerative disc disease. However, the use of additional anterior plating for 2-level ACDF remains controversial. Methods We reviewed outcomes of patients who underwent 2-level ACDF with stand-alone PEEK cages for CSM over a 7-year period (2007–2015) in a regional hospital. Japanese Orthopaedic Association (JOA) score, fusion rate, subsidence rate, cage migration, and cervical alignment by the C2–7 angle as well as the local segmental angle (LSA) of the cervical spine were assessed. Results In total, 31 patients (mean age, 59 years; range, 36–87 years) underwent 2-level ACDF with a cage-only construct procedure between 2007 and 2015. The minimum follow-up was 24 months; mean follow-up was 51 months. C3–5 fusion was performed in 45%, C4–6 fusion in 32%, and C5–7 fusion in 23%. Mean JOA score improved from 10.1±2.2 to 13.9±2.1 (p<0.01) at the 24-month follow-up. Fusion was achieved in all patients. Subsidence occurred in 22.5% of the cages but was not associated with differences in JOA scores, age, sex, or levels fused. Lordosis of the C2–7 angle and LSA increased after surgery, which were maintained for up to 1 year but subsequently disappeared after 2 years, yet the difference was not statistically significant. No cage migration was noted; two patients developed adjacent segment disease requiring posterior laminoplasty 3 years after ACDF. Conclusions The use of a stand-alone PEEK cage in a 2-level cervical interbody fusion achieves satisfactory improvements in both clinical outcomes and fusion.http://www.asianspinejournal.org/upload/pdf/asj-2018-0193.pdfCervical spondylotic myelopathyAnterior cervical discectomy and fusionStand-alone cageTwo level fusion |
spellingShingle | Eugene Pak-Lin Ng Andrew Siu-Leung Yip Keith Hay-Man Wan Michael Siu-Hei Tse Kam-Kwong Wong Tik-Koon Kwok Wing-Cheung Wong Stand-Alone Cervical Cages in 2-Level Anterior Interbody Fusion in Cervical Spondylotic Myelopathy: Results from a Minimum 2-Year Follow-up Asian Spine Journal Cervical spondylotic myelopathy Anterior cervical discectomy and fusion Stand-alone cage Two level fusion |
title | Stand-Alone Cervical Cages in 2-Level Anterior Interbody Fusion in Cervical Spondylotic Myelopathy: Results from a Minimum 2-Year Follow-up |
title_full | Stand-Alone Cervical Cages in 2-Level Anterior Interbody Fusion in Cervical Spondylotic Myelopathy: Results from a Minimum 2-Year Follow-up |
title_fullStr | Stand-Alone Cervical Cages in 2-Level Anterior Interbody Fusion in Cervical Spondylotic Myelopathy: Results from a Minimum 2-Year Follow-up |
title_full_unstemmed | Stand-Alone Cervical Cages in 2-Level Anterior Interbody Fusion in Cervical Spondylotic Myelopathy: Results from a Minimum 2-Year Follow-up |
title_short | Stand-Alone Cervical Cages in 2-Level Anterior Interbody Fusion in Cervical Spondylotic Myelopathy: Results from a Minimum 2-Year Follow-up |
title_sort | stand alone cervical cages in 2 level anterior interbody fusion in cervical spondylotic myelopathy results from a minimum 2 year follow up |
topic | Cervical spondylotic myelopathy Anterior cervical discectomy and fusion Stand-alone cage Two level fusion |
url | http://www.asianspinejournal.org/upload/pdf/asj-2018-0193.pdf |
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