Asian Spine J.  2019 Aug;13(4):630-637. 10.31616/asj.2018.0234.

Locking Stand-Alone Cage Constructs for the Treatment of Cervical Spine Degenerative Disease

Affiliations
  • 1Neurological Center, American British Cowdry Hospital, Mexico City, Mexico. dr.martinezanda@gmail.com

Abstract

STUDY DESIGN: Prospective case series study. PURPOSE: Description of the outcome of stand-alone cervical cages for single and multilevel cervical degenerative spine disease. OVERVIEW OF LITERATURE: The aim of anterior cervical discectomy and fusion (ACDF) for cervical spine disease is to improve patient symptoms and spine stability and restore lordosis. Locking stand-alone cages were developed with the goal of minimizing soft tissue disruption anterior to the vertebrae and reducing the profile of the construct by avoiding an anterior plate, thereby maximizing ACDF benefits.
METHODS
This study comprises a case series of patients surgically treated between July 2015 and February 2018 who received single or multilevel ACDF with a zero-profile stand-alone cervical cage. Surgical and clinical preoperative evaluation and surgical outcomes were evaluated using pre- and postoperative Nurick, Visual Analog Scale (VAS), Neck Disability Index (NDI), Japanese Orthopedic Association (JOA) score for myelopathy scales, cervical Cobb angles, postoperative surgical complications, and fusion and subsidence rates.
RESULTS
Fifty-three patients underwent ACDF; the mean age of these patients was 58.8 years, and their preoperative VAS, NDI, and JOA scores were 8.1, 31.6, and 15.3, respectively. The preoperative Cobb angle was 30.7°. Forty-five percent of patients had one-level, 54.7% had two-level, and 13.2% had three-level procedures. On preoperative magnetic resonance imaging, foraminal stenosis was present in 94.3% of patients, whereas medullar stenosis was present in 41.5%. The rate of complications was 5.7%: two patients had postoperative dysphagia (3.7%), and one patient had a surgical site hematoma. Mean postoperative follow-up time was 6.7 months; postoperative VAS, NDI, and JOA scores were 2.4, 15.9, and 15.8, respectively. Postoperative Cobb angle was 35.9°, fusion rate was 84.9%, and subsidence rate was 11.3%.
CONCLUSIONS
ACDF with zero-profile stand-alone cervical devices is an excellent option for cervical degenerative disc disease of one, two, and three levels, with similar results reported when using ACDF with either cage or plate.

Keyword

Cervical spondylosis; Spondylosis; Compressive myelopathy

MeSH Terms

Animals
Asian Continental Ancestry Group
Constriction, Pathologic
Deglutition Disorders
Diskectomy
Follow-Up Studies
Hematoma
Humans
Lordosis
Magnetic Resonance Imaging
Neck
Orthopedics
Prospective Studies
Spinal Cord Compression
Spinal Cord Diseases
Spine*
Spondylosis
Visual Analog Scale
Weights and Measures
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