EXPERIENCE WITH TITANIUM CAGES IN ANTERIOR CERVICAL DISCECTOMY AND FUSION

Authors

  • Muhammad Junaid Khyber Teaching Hospital, Peshawar
  • Mamoon Ur Rashid Khyber Teaching Hospital, Peshawar
  • Afeera Afsheen Khyber Teaching Hospital, Peshawar
  • Syed Sarmad Bukhari Khyber Teaching Hospital, Peshawar
  • Anisa Kalsoom Fauji Foundation Hospital Rawalpindi

Abstract

Background: Anterior cervical discectomy is a common procedure for treating patients for cervical disc prolapse. This study was conducted to study the surgical outcome and demographic characteristics of patients who were treated for anterior cervical disc prolapse. Methods: Study was conducted in the combined military hospital (CMH) Peshawar. Study interval was 3 years from 1st September, 2011 to 31st August, 2014. Total number of patients were 84. Males were 54 (64.28%) and females were 30 (35.71%). All the patients had undergone the procedure of anterior cervical discectomy and fusion with titanium cages (ACDF). All the patients had plain MRI cervical spine done for diagnosis of anterior cervical disc prolapse. Results: Total 84 patients were operated. In the patients who complained of brachialgia, 100% improvement was seen after the operation. Three (3.5%) of the patients, who presented with axial neck pain, continued to complain of pain and 2 (2.5%) of the patients complained of pain at the donor site after the operation. One of the patient had dural tear which resulted in subcutaneous cerebrospinal fluid (CSF) accumulation and was treated conservatively with repeated aspiration. Fusion rate was 100% with titanium cages used for fusion after anterior cervical discectomy. No complications were noted after the surgery at 1 year of interval. Conclusion: Results with titanium cages are expectedly good. Symptoms resolved and fusion rate was 100% at 1 year follow up.

References

Del Grande F, Maus TP, Carrino JA. Imaging the intervertebral disk: age-related changes, herniations, and radicular pain. Radiol Clin North Am 2012;50(4):629–49.

Hsu WK. Lumbar and cervical disk herniations in NFL players: Return to action. [An interview with welling K. Hua]. Orthopedics 2010;33(8):566–8.

Earhart JS, Roberts D, Roc G, Gryzlo S, Hsu W. Effects of Lumbar Disk Herniation on the Careers of Professional Baseball Players. Orthopedics 2012;35(1):43–9.

Peng B, Wu W, Li Z, Guo J, Wang X. Chemical radiculitis. Pain 2007;127(1):11–6.

Marshall LL, Trethewie ER. Chemical irritation of nerve-root in disc prolapse. Lancet 1973;11(7824):320.

McCarron RF, Wimpee MW, Hudkins PG, Laros GS. The inflammatory effect of nucleus pulposus. A possible element in the pathogenesis of low-back pain. Spine (Phila Pa 1976) 1987;12(8):760–4.

Takahashi H, Suguro T, Okazima Y, Motegi M, Okada Y, Kakiuchi T. Inflammatory cytokines in the herniated disc of the lumbar spine. Spine (Phila Pa 1976) 1996;21(2):218–24.

Igarashi T, Kikuchi S, Shubayev V, Myers RR. 2000 Volvo Award winner in basic science studies: Exogenous tumor necrosis factor-alpha mimics nucleus pulposus-induced neuropathology. Molecular, histologic, and behavioral comparisons in rats. Spine (Phila pa 1976) 2000;25(23):2975–80.

Sommer C, Schafers M. Mechanisms of neuropathic pain: the role of cytokines. Drug Discov Today Dis Mech 2004;1(4):441–8.

Séguin CA, Pilliar RM, Roughley PJ, Kandel RA. Tumor necrosis factor-alpha modulates matrix production and catabolism in nucleus pulposus tissue. Spine (Phila Pa 1976) 2005;30(17):1940–8.

Manusov, EG. Surgical treatment of low back pain. Prim Care 2012;39(3):525–31.

Xie JC, Hurlbert RJ. Discectomy versus discectomy with fusion versus discectomy with fusion and instrumentation: a prospective randomized study. Neurosurgery 2007;61(1):107–16.

Deftereos SN, Kechagias EA, Panagopoulos G, Seretis A, Orphanidis G, Antoniou E, et al. Localisation of cervical spinal cord compression by TMS and MRI. Functional neurology, 2009;24(2):99–105.

Vernon H, Mior S. The Neck Disability Index: a study of reliability and validity. J Manipulative Physiol Ther 1991;14(7):409–15.

Mobbs RJ, Rao P, Chandran NK. Anterior cervical discectomy and fusion: analysis of surgical outcome with and without plating. J Clin Neurosci 2007;14(7):639–42.

Dickerman RD, Reynolds AS, Morgan B. Polyetheretherketone (PEEK) cage filled with bone morphogenic protein and demineralised bone matrix in anterior cervical discectomy and fusion. Int Orthop 2008:32(5):717.

Fountas KN, Kapsalaki EZ, Nikolakakos LG, Smisson HF, Grigorian AA, Lee GP, et al. Anterior cervical discectomy and fusion associated complications. Spine (Phila Pa 1976) 2007;32(21):2310–7.

Bohlman HH, Emery SE, Goodfellow, DB, Jones PK. Robinson anterior cervical discectomy and arthrodesis for cervical radiculopathy. Long-term follow-up of one hundred and twenty-two patients. J Bone Joint Surg 1993;75(9):1298–307.

Johnson JP, Filler AG, McBride DQ, Batzdorf U. Anterior cervical foraminotomy for unilateral radicular disease. Spine (Phila Pa 1976) 2000;25(8):905–9.

Krupp W, Schattke H, Müke R. Clinical results of the foraminotomy as described by Frykholm for the treatment of lateral cervical disc herniation. Acta Neurochir 1990;107(1-2):22–9.

Silber JS, Anderson DG, Daffner SD, Brislin BT, Leland JM, Hilibrand AS, et al. Donor site morbidity after anterior iliac crest bone harvest for single-level anterior cervical discectomy and fusion. Spine (Phila Pa 1976) 2003;28(2):134–9.

Murrey D, Janssen M, Delamarter R, Goldstein J, Zigler J, Tay B, et al. Results of the prospective, randomized, controlled multicenter Food and Drug Administration investigational device exemption study of the ProDisc-C total disc replacement versus anterior discectomy and fusion for the treatment of 1-level symptomatic cervical disc disease. Spine J 2009;9(4):275–86.

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Published

2016-03-10

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