Evaluation of Subsidence in Stand-Alone Cervical Cage: Incidence, Risk Factors and Effects on Clinical and Radiological Picture

Background Data: Anterior Cervical Discectomy and Fusion is the gold standard for treating cervical degenerative disc disease associated with radiculopathy and/or myelopathy. When indicated, surgery can achieve neural tissue decompression and biomechanical stabilization through bony fusion. One of...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Salah Hamada, Ahmed Abou-Zeid
Formato:	article
Lenguaje:	EN
Publicado:	Egyptian Spine Association 2015
Materias:	anterior cervical discectomy fusion subsidence stand-alone; cage Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/f0f70bcd6da34690a32dbf6885c385a2
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:f0f70bcd6da34690a32dbf6885c385a2
record_format	dspace
spelling	oai:doaj.org-article:f0f70bcd6da34690a32dbf6885c385a22021-12-02T07:50:52ZEvaluation of Subsidence in Stand-Alone Cervical Cage: Incidence, Risk Factors and Effects on Clinical and Radiological PictureDOI:10.21608/ESJ.2015.39532314-89502314-8969https://doaj.org/article/f0f70bcd6da34690a32dbf6885c385a22015-04-01T00:00:00Zhttp://www.esj.journals.ekb.eg/article_3953.htmlhttps://doaj.org/toc/2314-8950https://doaj.org/toc/2314-8969Background Data: Anterior Cervical Discectomy and Fusion is the gold standard for treating cervical degenerative disc disease associated with radiculopathy and/or myelopathy. When indicated, surgery can achieve neural tissue decompression and biomechanical stabilization through bony fusion. One of the known complications of stand-alone anterior cervical cage is cage subsidence. Published literature however, contains mixed results in terms of rate of cage subsidence, loss of lordosis and its clinical effects. Purpose: We report our experience in stand-alone anterior cervical cage, our subsidence rate and its effect on loss of lordosis and clinical picture Study Design: Retrospective clinical case study. Patients and Methods: we inserted seventy-two cervical cages (in fifty patients), who had Anterior Cervical Discectomy and Fusion using a stand-alone polyetheretherketone (PEEK) cage under our care. We recorded the self-reported Visual Analogue Score for arm and neck pain and measured the total intervertebral height/disc space or cage ratio, segmental Cobb angle, the distance between the anterior rim of the cage and the anterior vertebral body line, superior or inferior end plate violation and anterior or posterior cage migration on lateral X ray film preoperatively and on each follow up visit (day 1, 7-21 days, 3, and 6 months). Results: Our cage subsidence rate in the studied sample was 23.6% in 6 months (17 out of 62 cages subsided). We found a statistically significant correlation between immediate postoperative disc height and subsidence (the more distraction we applied to the disc space the more likely subsidence would happen). Cage subsidence did not increase the incidence of recurrence of radicular, myelopathic symptoms or neck pain although it resulted in significant loss of the segmental Cobb angle. Conclusions: Disc space over-distraction in stand-alone anterior cervical cage significantly increases the risk of subsidence. Subsidence significantly affects the segmental Cobb angle but not the clinical outcome. (2015ESJ077)Salah Hamada Ahmed Abou-ZeidEgyptian Spine Associationarticleanterior cervical discectomyfusionsubsidencestand-alone; cageNeurology. Diseases of the nervous systemRC346-429ENEgyptian Spine Journal, Vol 14, Iss 1, Pp 24-31 (2015)
institution	DOAJ
collection	DOAJ
language	EN
topic	anterior cervical discectomy fusion subsidence stand-alone; cage Neurology. Diseases of the nervous system RC346-429
spellingShingle	anterior cervical discectomy fusion subsidence stand-alone; cage Neurology. Diseases of the nervous system RC346-429 Salah Hamada Ahmed Abou-Zeid Evaluation of Subsidence in Stand-Alone Cervical Cage: Incidence, Risk Factors and Effects on Clinical and Radiological Picture
description	Background Data: Anterior Cervical Discectomy and Fusion is the gold standard for treating cervical degenerative disc disease associated with radiculopathy and/or myelopathy. When indicated, surgery can achieve neural tissue decompression and biomechanical stabilization through bony fusion. One of the known complications of stand-alone anterior cervical cage is cage subsidence. Published literature however, contains mixed results in terms of rate of cage subsidence, loss of lordosis and its clinical effects. Purpose: We report our experience in stand-alone anterior cervical cage, our subsidence rate and its effect on loss of lordosis and clinical picture Study Design: Retrospective clinical case study. Patients and Methods: we inserted seventy-two cervical cages (in fifty patients), who had Anterior Cervical Discectomy and Fusion using a stand-alone polyetheretherketone (PEEK) cage under our care. We recorded the self-reported Visual Analogue Score for arm and neck pain and measured the total intervertebral height/disc space or cage ratio, segmental Cobb angle, the distance between the anterior rim of the cage and the anterior vertebral body line, superior or inferior end plate violation and anterior or posterior cage migration on lateral X ray film preoperatively and on each follow up visit (day 1, 7-21 days, 3, and 6 months). Results: Our cage subsidence rate in the studied sample was 23.6% in 6 months (17 out of 62 cages subsided). We found a statistically significant correlation between immediate postoperative disc height and subsidence (the more distraction we applied to the disc space the more likely subsidence would happen). Cage subsidence did not increase the incidence of recurrence of radicular, myelopathic symptoms or neck pain although it resulted in significant loss of the segmental Cobb angle. Conclusions: Disc space over-distraction in stand-alone anterior cervical cage significantly increases the risk of subsidence. Subsidence significantly affects the segmental Cobb angle but not the clinical outcome. (2015ESJ077)
format	article
author	Salah Hamada Ahmed Abou-Zeid
author_facet	Salah Hamada Ahmed Abou-Zeid
author_sort	Salah Hamada
title	Evaluation of Subsidence in Stand-Alone Cervical Cage: Incidence, Risk Factors and Effects on Clinical and Radiological Picture
title_short	Evaluation of Subsidence in Stand-Alone Cervical Cage: Incidence, Risk Factors and Effects on Clinical and Radiological Picture
title_full	Evaluation of Subsidence in Stand-Alone Cervical Cage: Incidence, Risk Factors and Effects on Clinical and Radiological Picture
title_fullStr	Evaluation of Subsidence in Stand-Alone Cervical Cage: Incidence, Risk Factors and Effects on Clinical and Radiological Picture
title_full_unstemmed	Evaluation of Subsidence in Stand-Alone Cervical Cage: Incidence, Risk Factors and Effects on Clinical and Radiological Picture
title_sort	evaluation of subsidence in stand-alone cervical cage: incidence, risk factors and effects on clinical and radiological picture
publisher	Egyptian Spine Association
publishDate	2015
url	https://doaj.org/article/f0f70bcd6da34690a32dbf6885c385a2
work_keys_str_mv	AT salahhamada evaluationofsubsidenceinstandalonecervicalcageincidenceriskfactorsandeffectsonclinicalandradiologicalpicture AT ahmedabouzeid evaluationofsubsidenceinstandalonecervicalcageincidenceriskfactorsandeffectsonclinicalandradiologicalpicture
_version_	1718399194674233344

Evaluation of Subsidence in Stand-Alone Cervical Cage: Incidence, Risk Factors and Effects on Clinical and Radiological Picture

Ejemplares similares