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Biomechanical evaluation of single- and multi-level anterior cervical discectomy and fusion with polyetheretherketone cages: radiological and clinical outcomes
Affiliations- Department of Pediatric Radiology, Medical University of Bialystok, Bialystok, Poland
- Department of Pediatric Orthopedics, Medical University of Bialystok, Poland
- Department of Neurosurgery, Brodno Masovian Hospital, Warsaw, Poland
- Department of Neurosurgery, Medical University of Bialystok, Poland
- Department of Pediatric Surgery and Urology, Medical University of Bialystok, Poland
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Abstract
Objective. The aim of this study was to analyse the outcomes of single- and multi-level anterior cervical discectomy and fusion (ACDF) with standalone polyetheretherketone (PEEK) cages, with particular emphasis on the risk of secondary adjacent segment disease.
Materials and methods. This retrospective study included 30 patients with single- or multi-level cervical disc herniation. Before the ACDF, and one year thereafter, the patients underwent clinical and radiological evaluation including determination of cervical pain severity with a numerical rating scale (NRS), and a survey with a Polish adaptation of the neck disability index questionnaire (NDI-PL). Biomechanical parameters of the cervical spine were determined using the Cobb method.
Results. One year after ACDF, all patients had achieved complete fusions, and 97% showed a significant reduction of pain severity. Also, a significant decrease in all NDI-PL indices was observed. A significant decrease in overall cervical spine mobility coexisted with a significant increase in the mobility of the segment above the one operated upon and a non-significant decrease in the mobility of the segment below. No statistically significant change was found in the intervertebral disc space height (IVH) above and below the operated segment, and no evidence of degeneration within the segments adjacent to the operated one was documented.
Conclusion. One- and two-level ACDF with standalone PEEK cages provided high fusion rates. Surgical spondylosis contributed to a reduction of spinal mobility despite the hypermobility in adjacent spinal segments. No degeneration in adjacent spinal segments was documented within a year of ACDF, and the treatment seemed to improve patients’ quality of life.
Abstract
Objective. The aim of this study was to analyse the outcomes of single- and multi-level anterior cervical discectomy and fusion (ACDF) with standalone polyetheretherketone (PEEK) cages, with particular emphasis on the risk of secondary adjacent segment disease.
Materials and methods. This retrospective study included 30 patients with single- or multi-level cervical disc herniation. Before the ACDF, and one year thereafter, the patients underwent clinical and radiological evaluation including determination of cervical pain severity with a numerical rating scale (NRS), and a survey with a Polish adaptation of the neck disability index questionnaire (NDI-PL). Biomechanical parameters of the cervical spine were determined using the Cobb method.
Results. One year after ACDF, all patients had achieved complete fusions, and 97% showed a significant reduction of pain severity. Also, a significant decrease in all NDI-PL indices was observed. A significant decrease in overall cervical spine mobility coexisted with a significant increase in the mobility of the segment above the one operated upon and a non-significant decrease in the mobility of the segment below. No statistically significant change was found in the intervertebral disc space height (IVH) above and below the operated segment, and no evidence of degeneration within the segments adjacent to the operated one was documented.
Conclusion. One- and two-level ACDF with standalone PEEK cages provided high fusion rates. Surgical spondylosis contributed to a reduction of spinal mobility despite the hypermobility in adjacent spinal segments. No degeneration in adjacent spinal segments was documented within a year of ACDF, and the treatment seemed to improve patients’ quality of life.
Keywords
adjacent segment degeneration, adjacent segment disease, anterior cervical discectomy with fusion, cervical myelopathy, cervical radiculopathy, PEEK cages
About this articleTitle
Biomechanical evaluation of single- and multi-level anterior cervical discectomy and fusion with polyetheretherketone cages: radiological and clinical outcomes
Journal
Neurologia i Neurochirurgia Polska
Issue
Article type
Research Paper
Pages
358-362
Published online
2019-09-20
Page views
2295
Article views/downloads
469
DOI
Pubmed
Bibliographic record
Neurol Neurochir Pol 2019;53(5):358-362.
Keywords
adjacent segment degeneration
adjacent segment disease
anterior cervical discectomy with fusion
cervical myelopathy
cervical radiculopathy
PEEK cages
Authors
Gabriela Zapolska
Michał Kwiatkowski
Grzegorz Turek
Zenon Mariak
Adam Hermanowicz
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