| Operated and adjacent segment motions for fusion versus cervical arthroplasty: a pilot study. | |
| | |
MedLine Citation:
|
PMID: 21053112 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
BACKGROUND: Anterior cervical discectomy and fusion (ACDF) represent the standard treatment for cervical spondylolytic radiculopathy and myelopathy. To achieve solid fusion, appropriate compressive loading of the graft and stability are essential. Fusion may lead to adjacent segment degeneration. Artificial discs have been introduced as motion-preserving devices to reduce the risk of fusion-related complications. QUESTIONS/PURPOSES: We therefore asked: (1) Does the use of a plate reduce motion at the operated level and bone graft compression compared to fusion with bone graft alone; and (2) is adjacent-segment motion higher after fusion with a plate? METHODS: Motions and compressive loads in the graft were quantified for intact, C4-C5 ACDF without and with a plate, and total disc arthroplasty in human cadaver spines. RESULTS: At the surgery level all motions decreased for ACDF with a plate. The motions were similar to intact motions after total disc arthroplasty. The motions across the adjacent segment increased after fusion in all loading modes except lateral bending and were closer to the intact for the total disc arthroplasty case. The plate maintained a compressive load on the graft with a maximum increase in extension. CONCLUSIONS: Unlike fusion, the arthroplasty can restore motion to normal at the surgery and adjacent segments, compared to fusion cases. A cervical plate with a precompression of the graft provides enhanced stability and fusion due to improved compression. CLINICAL RELEVANCE: Our findings support the clinical observations that fusion may lead to the degeneration of the adjacent segments. Disc arthroplasty may be able to circumvent the adjacent segment degeneration. |
| | |
Authors:
|
Tomoya Terai; Ahmad Faizan; Koichi Sairyo; Vijay K Goel |
Publication Detail:
|
Type: Comparative Study; Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
|
Title: Clinical orthopaedics and related research Volume: 469 ISSN: 1528-1132 ISO Abbreviation: Clin. Orthop. Relat. Res. Publication Date: 2011 Mar |
Date Detail:
|
Created Date: 2011-02-03 Completed Date: 2011-03-24 Revised Date: 2012-03-01 |
Medline Journal Info:
|
Nlm Unique ID: 0075674 Medline TA: Clin Orthop Relat Res Country: United States |
Other Details:
|
Languages: eng Pagination: 682-7 Citation Subset: AIM; IM |
Affiliation:
|
Engineering Center for Orthopaedic Research Excellence (E-CORE), Department of Bioengineering, College of Engineering, University of Toledo, Toledo, OH, USA. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Arthroplasty
/
methods* Bone Plates / adverse effects Bone Transplantation Cervical Vertebrae / physiopathology, surgery* Diskectomy Humans Intervertebral Disc Degeneration / etiology*, prevention & control Movement / physiology Osseointegration Pilot Projects Postoperative Complications Spinal Fusion / adverse effects, instrumentation, methods* Spondylosis / surgery* Stress, Mechanical Weight-Bearing |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Odontogenic epithelium: immunolabeling of Ki-67, EGFR and survivin in pericoronal follicles, dentige...
Next Document: HSFs and regulation of Hsp70.1 (Hspa1b) in oocytes and preimplantation embryos: new insights brought...