Volume 5, 2019
|Number of page(s)||7|
|Published online||08 February 2019|
The use of anterior cervical interbody spacer with integrated fixation screws for management of cervical disc disease
Agouza Armed Forces Spine Surgery Center, Farid Shawky Street, Giza, Egypt
2 Orthopedics and Traumatology Department, Faculty of Medicine, Cairo University, Kasr Alainy Street, Cairo, Egypt
* Corresponding author: firstname.lastname@example.org
Accepted: 8 January 2019
Introduction: Integrated cage and screw designs were introduced for anterior cervical discectomy and fusion (ACDF) and allegedly are superior to anterior plating due to their minimal anterior profile.
Methods: A descriptive study was designed as a prospective case series of 25 patients (30 operated discs) with cervical disc disease treated with a zero-profile cage, and followed up for an average of 16 months (range 12 –18 months). Functional assessment was done with the Neck Disability Index (NDI) and Visual analog scale (VAS) scores for arm and neck pain. Furthermore, Nurick’s classification system for myelopathy based on gait abnormalities was documented. Radiological fusion was confirmed with plain X-rays and when indicated with a CT scan at 12 months postoperatively. Dysphagia was classified according to the Bazaz criteria.
Results: VAS for neck and arm pain, NDI, and Nurick Score immediately improved postoperatively and remained so at 12-month follow-up. Fusion was achieved in 19 patients (95%) at six months and in 20 patients (100%) of the single-level group at one year. At six months 80% (four patients) and at 12 months 100% (five patients) showed complete union in the double-level group.
No evidence of cage subsidence was noted radiographically.
Discussion: The favorable lordosis and fusion rates of the low-profile integrated device are consistent with ACDF using anterior plating. Additionally, improved pain and an acceptable rate of dysphagia support the use of integrated interbody spacers for use in ACDF procedures.
Key words: Cervical disc disease / Integrated interbody spacer with zero-profile / Dysphagia after cervical fusion / ACDF / Cervical lordosis and cage subsidence
© The Authors, published by EDP Sciences, 2019
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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