| Dynamic anterior cervical plates for multilevel anterior corpectomy and fusion with simultaneous posterior wiring and fusion: efficacy and outcomes. | |
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MedLine Citation:
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PMID: 16317424 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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N E Epstein |
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Publication Detail:
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Type: Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't Date: 2005-11-29 |
Journal Detail:
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Title: Spinal cord Volume: 44 ISSN: 1362-4393 ISO Abbreviation: Spinal Cord Publication Date: 2006 Jul |
Date Detail:
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Created Date: 2006-07-04 Completed Date: 2006-09-12 Revised Date: 2011-06-06 |
Medline Journal Info:
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Nlm Unique ID: 9609749 Medline TA: Spinal Cord Country: England |
Other Details:
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Languages: eng Pagination: 432-9 Citation Subset: IM |
Affiliation:
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Department of Neurological Surgery, The Albert Einstein College of Medicine, Bronx, NY, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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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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