Long-Term Follow-Up Results of Anterior Cervical Inter-Body Fusion with Stand-Alone Cages |
| |
Authors: | Woong-Beom Kim Seung-Jae Hyun Hoyong Choi Ki-Jeong Kim Tae-Ahn Jahng Hyun-Jib Kim |
| |
Affiliation: | Department of Neurosurgery, Spine Center, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea. |
| |
Abstract: | ObjectiveThe purpose of this study was to evaluate long-term follow-up radiologic/clinical outcomes of patients who underwent anterior cervical discectomy and inter-body fusion (ACDF) with stand-alone cages (SAC) in a single academic institution.MethodsTotal 99 patients who underwent ACDF with SAC between February 2004 and December 2012 were evaluated retrospectively. A total of 131 segments were enrolled in this study. Basic demographic information, radiographic [segmental subsidence rate, fusion rate, C2–7 global angle, and segmental angle changes)/clinical outcomes (by Odom''s criteria and visual analog score (VAS)] and complications were evaluated to determine the long-term outcomes.ResultsThe majority were males (55 vs. 44) with average age of 53.2. Mean follow-up period was 62.9 months. The segmental subsidence rate was 53.4% and fusion rate was 73.3%. In the subsidence group, anterior intervertebral height (AIH) had more tendency of subsiding than middle or posterior intervertebral height (p=0.01). The segmental angle led kyphotic change related to the subsidence of the AIH. Adjacent segmental disease was occurred in 18 (18.2%) patients. Total 6 (6%) reoperations were performed at the index level. There was no statistical significance between clinical and radiological outcomes. But, overall long-term clinical outcome by Odom''s criteria was unsatisfactory (64.64%). The neck and arm VAS score were increased by over time.ConclusionLong-term outcomes of ACDF with SAC group were acceptable but not satisfactory. For optimal decision making, more additional comparative long-term outcome data is needed between ACDF with SAC and ACDF with plating. |
| |
Keywords: | Anterior cervical discectomy and fusion Stand-alone cage Subsidence Long-term outcomes Intervertebral height Odom''s criteria |
|
|