Document Detail


The efficacy of plate construct augmentation versus cage alone in anterior cervical fusion.
MedLine Citation:
PMID:  19949367     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
STUDY DESIGN.: Retrospective study. OBJECTIVE.: To compare the efficacy of anterior cervical discectomy and fusion with cage alone (ACDF-CA) with cage and plate construct (ACDF-CPC) in regards to fusion rate, radiologic and clinical outcomes. SUMMARY OF BACKGROUND DATA.: ACDF-CA has shown good results; however, debate exists regarding the high rate of complications such as pseudarthrosis, subsidence, and local kyphosis. In an attempt to avoid these complications, the authors have performed ACDF with cage and plate construct (ACDF-CPC). METHODS.: A total of 78 consecutive patients who underwent 1- or 2-level ACDF-CA or ACDF-CPC suffering from cervical radiculopathy were divided into 2 groups; Group A (n = 38) underwent ACDF-CA; Group B (n = 40) underwent ACDF-CPC. Fusion rate, segmental kyphosis, disc height, and subsidence rate were assessed by radiographs. Clinical outcomes were assessed using Robinson criteria. RESULTS.: Solid fusion was achieved in 78.9% (30/38) of subjects in group A compared to 97.5% (39/40) of subjects in group B (P = 0.01). Segmental kyphosis was noted in 42.1% (16/38) in group A compared with 10% (4/40) in group B (P < 0.01). There was a significant decrease in disc height in group A compared to group B (P < 0.05). Subsidence occurred in 32.3% (19/59 levels) of group A compared with 9.7% (6/62 levels) of group B (P < 0.01). Clinical outcomes were similar for both treatment groups. The pseudarthrosis rate in group A was higher than that in group B (P = 0.01). Revision surgery was required in 10.5% (4/38) of group A, whereas none of group B required reoperation (P < 0.01). CONCLUSION.: The use of cage and plate construct in 1- or 2-level ACDF results in a more lordotic alignment, an increased disc height, a higher fusion rate, a lower subsidence rate, and a lower complication rate than that of cage alone; however, there is no significant difference in clinical outcome between groups.
Authors:
Kyung-Jin Song; Cyrus E Taghavi; Kwang-Bok Lee; Ji-Hoon Song; Jong-Pil Eun
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Spine     Volume:  34     ISSN:  1528-1159     ISO Abbreviation:  Spine     Publication Date:  2009 Dec 
Date Detail:
Created Date:  2009-12-17     Completed Date:  2010-02-19     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7610646     Medline TA:  Spine (Phila Pa 1976)     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2886-92     Citation Subset:  IM    
Affiliation:
Department of Orthopaedic Surgery, Research Institute of Clinical Medicine, Chonbuk National University School of Medicine, Jeonju, Korea.
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MeSH Terms
Descriptor/Qualifier:
Adult
Bone Plates
Bone Transplantation
Cervical Vertebrae / radiography,  surgery*
Diskectomy / adverse effects,  methods*
Female
Humans
Internal Fixators
Kyphosis / etiology,  radiography
Male
Pain, Postoperative
Radiculopathy / radiography,  surgery*
Retrospective Studies
Spinal Fusion / adverse effects,  methods*
Spine / radiography,  surgery*
Treatment Outcome

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


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