J Korean Soc Spine Surg.  2009 Jun;16(2):71-78. 10.4184/jkss.2009.16.2.71.

Efficiency of Anterior Interbody Fusion using Cage and Plate in the Distractive Flexion Injury of Cervical Spine : Cage vs Tricortical Autoiliac Bone

• Park HJ
• Kim WK
• Ryu HY

• KMID: 2209600
• DOI: http://doi.org/10.4184/jkss.2009.16.2.71

Abstract

STUDY DESIGN: This is a retrospective study
OBJECTIVES
We wanted to evaluate the effectiveness and safety of anterior interbody fusion (AIF) using cage and plate fixation for treating distractive flexion injury of the cervical spine according to the radiological and clinical outcomes. SUMMARY OF THE LITERATURE REVIEW: AIF of the cervical spine using autoiliac bone and plate fixation is known as an effective method for treating not only degenerative disease, but also trauma as well. However, the problem lies in the complications that occur at the donor site. To avoid these complications, the fusion method using a cage is becoming more frequently used, but there are not many reports on using a cage and plate for treating trauma in the cervical spine.
MATERIALS AND METHODS
We retrospectively analyzed 47 patients with distractive flexion injury of the cervical spine and who underwent anterior decompression and interbody fusion with a autoiliac bone graft and plate fixation (Group I, 32 patients) or who underwent anterior decompression and interbody fusion with cage and plate fixation (Group II, 15 patients). We statistically analyzed the changes of the segmental lordosis, the fused segmental body height, the fusion rate on plain radiography and the neurologic recovery with using an ASIA scoring system.
RESULTS
All the cases were fused by 12.6+/-2.5weeks after operation. The changes of segmental lordosis shows no statistical difference between the two groups (p=0.69). The anterior and posterior vertebral heights of the fused segments of Group I were more decreased than those of Group II, and there was a statistical difference between the two groups (p=0.03, 0.04). The initial and last follow up neurologic statuses were not statistically difference between the two groups (p=0.11)
CONCLUSIONS
For the treatment of fracture-dislocation injury in the cervical spine, AIF using a PEEK cage filled with autoiliac bone and plate fixation is an effective method with the least possibility of complications at the donor site, and at the same time, this surgical method shows equally satisfactory results, both radiologically and clinically, as fusion with using a tricortical autoiliac bone graft.

Keyword

Cervical spine; Distractive flexion injury; Anterior interbody fusion; Cage

MeSH Terms

Animals
Asia
Body Height
Decompression
Follow-Up Studies
Humans
Ketones
Lordosis
Polyethylene Glycols
Retrospective Studies
Spine
Tissue Donors
Transplants
Ketones
Polyethylene Glycols

Figure

• 

  Fig. 1. A 52-year old male with C6 nerve root injury due to unilateral facet dislocation. (A) Preoperative lateral roentgenogram shows anterior displacement of C5 on C6 body. (B) T2 weighted sagittal MR image shows a C5-6 disc protrusion. (C) Lateral radiograph, immediately after surgery, shows anterior cervical fusion with cervical spine locking plate and tricortical autoiliac bone. (D, E) Lateral roentgenogram of flexion/extension views that show no motion and solid fusion.

• 

  Fig. 2. A 43-year old male with C5 nerve root injury due to bilateral facet dislocation. (A) Preoperative lateral roentgenogram shows anterior displacement of C5 on C6 body. (B) T2 weighted sagittal MR image shows a C5-6 disc protrusion. (C) Lateral radiograph, immediately after surgery, shows anterior cervical fusion with cervical spine locking plate and Solis PEEK cage that packed with cancellous iliac bone. (D, E) Lateral roentgenogram of flexion/extension views that show no motion and solid fusion.

• 

  Fig. 3. Radiograph showing linear and angular measurement.

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