Document Detail


Dynamic anterior cervical plates for multilevel anterior corpectomy and fusion with simultaneous posterior wiring and fusion: efficacy and outcomes.
MedLine Citation:
PMID:  16317424     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
STUDY DESIGN: To prospectively evaluate major complications associated with the application of dynamic ABC plates (Aesculap, Tuttlingen, Germany) to multilevel Anterior Corpectomy/Fusion (ACF) followed by posterior fusion (C2-C7 PF).
OBJECTIVES: To determine whether dynamic ABC (Aesculap, Tuttlingen, Germany) plates would minimize major complications (plate/graft extrusion, pseudarthrosis) while maximizing neurological outcomes in 40 consecutive patients undergoing simultaneous multilevel ACF/PF with halo application.
SETTING: USA.
METHODS: Patients averaged 53 years of age and preoperatively exhibited severe myeloradiculopathy (Nurick Grade 3.9). MR/CT studies documented marked ossification of the posterior longitudinal ligament/spondylostenosis. Surgery included two to four level ACF utilizing fibula strut allograft and ABC plates. Posterior spinous process wiring/fusions utilized braided titanium cables. The average operative time was 8.9 h. Fusion was confirmed on dynamic X-rays/CTs (3-12 months postoperatively). The average follow-up interval was 2.7 years. Outcomes (3 months-2 years postoperatively) were assessed utilizing Odom's Criteria, Nurick Grades, and SF-36 questionnaires.
RESULTS: Major complications included one pseudarthrosis requiring secondary PWF. Minor complications in six patients included two pulmonary emboli (PE), two tracheostomies, and five superficial wound infections. At 1 year postoperatively, marked improvement was observed in all patients utilizing Odom's criteria (38 excellent/good), Nurick Grades (mild radiculopathy 0.4), and the SF-36 (3 Health Scales; Role Physical (12.5-38.6), Bodily Pain (39.9-65.5), and Role Emotional (53.8-75.8)]. The 2-year postoperative data showed minimal additional improvement. The average time to fusion was 6.3 months.
CONCLUSION: Patients undergoing multilevel ACF/PF demonstrated marked neurological improvement (SF-36), and only one of 40 developed a delayed pseudarthrosis.
Authors:
N E Epstein
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Publication Detail:
Type:  Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't     Date:  2005-11-29
Journal Detail:
Title:  Spinal cord     Volume:  44     ISSN:  1362-4393     ISO Abbreviation:  Spinal Cord     Publication Date:  2006 Jul 
Date Detail:
Created Date:  2006-07-04     Completed Date:  2006-09-12     Revised Date:  2011-06-06    
Medline Journal Info:
Nlm Unique ID:  9609749     Medline TA:  Spinal Cord     Country:  England    
Other Details:
Languages:  eng     Pagination:  432-9     Citation Subset:  IM    
Affiliation:
Department of Neurological Surgery, The Albert Einstein College of Medicine, Bronx, NY, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Bone Plates*
Bone Wires*
Cervical Vertebrae / surgery*
Combined Modality Therapy
Female
Humans
Laminectomy / adverse effects,  instrumentation*,  methods
Male
Middle Aged
Radiculopathy / etiology,  prevention & control*
Spinal Fusion / adverse effects,  instrumentation*,  methods
Spinal Stenosis / complications,  surgery*
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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