Two or More Levels Anterior Cervical Discectomy and Fusion (ACDF) Using Stand-Alone PEEK Cages Filled With Bone Graft Substitute

Background Data: Anterior cervical discectomy and fusion (ACDF) has become a standard and a highly successful procedure for degenerative cervical disc disease associated with radiculopathy or myelopathy. In addition to graft complication, multilevel cervical discectomy is often combined with plate f...

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Autores principales: Mohamad El-Meshtawy, Belal Elnady, Khaled Hassan, Hamdan Ahmad, Mohamad Hassan, Mahmoud Fouad, Amr Abo El-Fadl
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Publicado: Egyptian Spine Association 2013
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spelling oai:doaj.org-article:1991aa2e5625473b8d3fe36ec083b6f42021-12-02T03:45:17ZTwo or More Levels Anterior Cervical Discectomy and Fusion (ACDF) Using Stand-Alone PEEK Cages Filled With Bone Graft SubstituteDOI:10.21608/ESJ.2013.38172314-89502314-8969https://doaj.org/article/1991aa2e5625473b8d3fe36ec083b6f42013-04-01T00:00:00Zhttp://esj.journals.ekb.eg/article_3817.htmlhttps://doaj.org/toc/2314-8950https://doaj.org/toc/2314-8969Background Data: Anterior cervical discectomy and fusion (ACDF) has become a standard and a highly successful procedure for degenerative cervical disc disease associated with radiculopathy or myelopathy. In addition to graft complication, multilevel cervical discectomy is often combined with plate fixation to maintain the spinal curvature, and increasing the graft fusion rate but this also may carry risk of complications. Study Design: Prospective descriptive clinical case study Purpose: To evaluate the safety and efficacy of standalone PEEK cages filled with bone graft substitute in treatment of multi-level cervical disc disease. Patients and Methods: Ninety one patients underwent multiple levels ACDF for a total of 239 levels. Mean follow-up was 24 months. Clinical outcomes were evaluated using Visual Analogue Scale (VAS) and Oswestry Disability Index (ODI); cervical lordosis and cervical fusion status was assessed on X-ray. Statistical analysis was performed using a dependent t-test using SPSS V.12.0 (P<0.05). Results: The fusion rate was 97.9% (234 out of total 239 levels operated). Clinically, the mean ODI scores were 50.49 (Range, 30 to 69) preoperatively and 16.89 (Range, 0 to 38) postoperatively (P=0.000). All patient have significant pain reduction with mean VAS scores decreases from 6.52 (Range, 4 to 9) preoperative to 1.87 (Range, 0 to 5) postoperatively (P=0.000). Cervical lordosis was preserved and neurological status was improved. No cage migration or cage breakage happened. Conclusion: ACDF using standalone PEEK cages filled with Calcium triphosphate bone graft substitute is a safe and efficient method for treatment of multiple levels cervical disc disease. It preserves cervical lordosis and obviates the complications related to iliac crest grafting and screw-plate fixation. (2013ESJ045)Mohamad El-Meshtawy Belal ElnadyKhaled Hassan Hamdan AhmadMohamad Hassan Mahmoud Fouad Amr Abo El-FadlEgyptian Spine Associationarticlecervical spineMulti-level cervical disc diseaseACDFPEEK cageNeurology. Diseases of the nervous systemRC346-429ENEgyptian Spine Journal, Vol 6, Iss 1, Pp 30-37 (2013)
institution DOAJ
collection DOAJ
language EN
topic cervical spine
Multi-level cervical disc disease
ACDF
PEEK cage
Neurology. Diseases of the nervous system
RC346-429
spellingShingle cervical spine
Multi-level cervical disc disease
ACDF
PEEK cage
Neurology. Diseases of the nervous system
RC346-429
Mohamad El-Meshtawy
Belal Elnady
Khaled Hassan
Hamdan Ahmad
Mohamad Hassan
Mahmoud Fouad
Amr Abo El-Fadl
Two or More Levels Anterior Cervical Discectomy and Fusion (ACDF) Using Stand-Alone PEEK Cages Filled With Bone Graft Substitute
description Background Data: Anterior cervical discectomy and fusion (ACDF) has become a standard and a highly successful procedure for degenerative cervical disc disease associated with radiculopathy or myelopathy. In addition to graft complication, multilevel cervical discectomy is often combined with plate fixation to maintain the spinal curvature, and increasing the graft fusion rate but this also may carry risk of complications. Study Design: Prospective descriptive clinical case study Purpose: To evaluate the safety and efficacy of standalone PEEK cages filled with bone graft substitute in treatment of multi-level cervical disc disease. Patients and Methods: Ninety one patients underwent multiple levels ACDF for a total of 239 levels. Mean follow-up was 24 months. Clinical outcomes were evaluated using Visual Analogue Scale (VAS) and Oswestry Disability Index (ODI); cervical lordosis and cervical fusion status was assessed on X-ray. Statistical analysis was performed using a dependent t-test using SPSS V.12.0 (P<0.05). Results: The fusion rate was 97.9% (234 out of total 239 levels operated). Clinically, the mean ODI scores were 50.49 (Range, 30 to 69) preoperatively and 16.89 (Range, 0 to 38) postoperatively (P=0.000). All patient have significant pain reduction with mean VAS scores decreases from 6.52 (Range, 4 to 9) preoperative to 1.87 (Range, 0 to 5) postoperatively (P=0.000). Cervical lordosis was preserved and neurological status was improved. No cage migration or cage breakage happened. Conclusion: ACDF using standalone PEEK cages filled with Calcium triphosphate bone graft substitute is a safe and efficient method for treatment of multiple levels cervical disc disease. It preserves cervical lordosis and obviates the complications related to iliac crest grafting and screw-plate fixation. (2013ESJ045)
format article
author Mohamad El-Meshtawy
Belal Elnady
Khaled Hassan
Hamdan Ahmad
Mohamad Hassan
Mahmoud Fouad
Amr Abo El-Fadl
author_facet Mohamad El-Meshtawy
Belal Elnady
Khaled Hassan
Hamdan Ahmad
Mohamad Hassan
Mahmoud Fouad
Amr Abo El-Fadl
author_sort Mohamad El-Meshtawy
title Two or More Levels Anterior Cervical Discectomy and Fusion (ACDF) Using Stand-Alone PEEK Cages Filled With Bone Graft Substitute
title_short Two or More Levels Anterior Cervical Discectomy and Fusion (ACDF) Using Stand-Alone PEEK Cages Filled With Bone Graft Substitute
title_full Two or More Levels Anterior Cervical Discectomy and Fusion (ACDF) Using Stand-Alone PEEK Cages Filled With Bone Graft Substitute
title_fullStr Two or More Levels Anterior Cervical Discectomy and Fusion (ACDF) Using Stand-Alone PEEK Cages Filled With Bone Graft Substitute
title_full_unstemmed Two or More Levels Anterior Cervical Discectomy and Fusion (ACDF) Using Stand-Alone PEEK Cages Filled With Bone Graft Substitute
title_sort two or more levels anterior cervical discectomy and fusion (acdf) using stand-alone peek cages filled with bone graft substitute
publisher Egyptian Spine Association
publishDate 2013
url https://doaj.org/article/1991aa2e5625473b8d3fe36ec083b6f4
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