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Erschienen in: European Orthopaedics and Traumatology 2/2014

01.06.2014 | Original Article

Results of ACDF using Alexandria Modular Cage-Plate Construct in cervical canal stenosis

verfasst von: Ahmed Ezzat Siam, Hesham El Saghir, Tarek El-Fiky, Osama Moustafa, Yasser El Mansy

Erschienen in: European Orthopaedics and Traumatology | Ausgabe 2/2014

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Abstract

Background

The purpose of this study was to assess prospectively operative results and complications of treatment of cervical spinal canal stenosis (CCS) by anterior cervical discectomy and fusion (ACDF) using a newly introduced Alexandria Modular Cage-Plate Construct (AMCPC).

Methods

Fifteen patients (eight males, seven females) with symptomatic CCS were treated by ACDF, with a mean age of 51.2 years. Post-operative assessment depended upon clinical and radiological results.

Results

Total number of operated levels was 25 levels, with a mean 1.67 levels/patient. Mean operative time was 69.6 min/level and 116 min/patient. Average blood loss was 78 mL/level and 130 mL/patient. Mean hospital stay was 2.8 days. Post-operative dysphagia/dysphonia persisted in one patient for 1 year. One patient developed C5 radiculopathy with grade 2 deltoid weakness that recovered after 3 months. According to Odom’s criteria, results were excellent in 13 patients (86.67 %), good in 1 (6.67 %), and fair in 1 patient. In 13 patients (23 cage-plates, 92 %), the implant showed to be completely contained until the end of follow-up (24 months). One patient had a broken screw and one had screw backing-out, both did not necessitate revision. The achieved sagittal profile was maintained without sinking-in of any cage.

Conclusion

AMCPC can be used safely for a variety of disorders requiring instrumentation and fusion. It is advantageous to stand-alone cage and to rigid cage-plates when intraoperative flexibility is needed. It overcomes the disadvantages of stand-alone cage, sinking-in, cage dislodgement and post-operative rekyphosis. In addition, it obviates the need for wearing post-operative neck collar.
Literatur
1.
Zurück zum Zitat Rishi DS, Ronald HMA, Wilco CP (2007) Long-term outcome after anterior cervical discectomy without fusion. Eur Spine J 16:1411–1416CrossRef Rishi DS, Ronald HMA, Wilco CP (2007) Long-term outcome after anterior cervical discectomy without fusion. Eur Spine J 16:1411–1416CrossRef
3.
Zurück zum Zitat Vanek P, Bradac O, Delacy P, Saur K, Belsan T, Benes V (2012) Comparison of 3 fusion techniques in the treatment of the degenerative cervical spine disease. Is stand-alone autograft really the “gold standard?”: prospective study with 2-year follow-up. Spine 37(19):1645–1651PubMedCrossRef Vanek P, Bradac O, Delacy P, Saur K, Belsan T, Benes V (2012) Comparison of 3 fusion techniques in the treatment of the degenerative cervical spine disease. Is stand-alone autograft really the “gold standard?”: prospective study with 2-year follow-up. Spine 37(19):1645–1651PubMedCrossRef
4.
Zurück zum Zitat Thorell W, Cooper J, Hellbusch L, Leibrock L (1998) The long-term clinical outcome of patients undergoing anterior cervical discectomy with and without intervertebral bone graft placement. Neurosurgery 43(2):268–274PubMedCrossRef Thorell W, Cooper J, Hellbusch L, Leibrock L (1998) The long-term clinical outcome of patients undergoing anterior cervical discectomy with and without intervertebral bone graft placement. Neurosurgery 43(2):268–274PubMedCrossRef
5.
Zurück zum Zitat Sonntag VK, Klara P (1996) Controversy in spine care. Is fusion necessary after anterior cervical discectomy? Spine 21(9):1111–1113PubMedCrossRef Sonntag VK, Klara P (1996) Controversy in spine care. Is fusion necessary after anterior cervical discectomy? Spine 21(9):1111–1113PubMedCrossRef
6.
Zurück zum Zitat Jacobs WCH, Anderson PG, Van Limbeek J, Willems PC, Pavlov P (2004) Single or double-level anterior interbody fusion techniques for cervical degenerative disc disease. Cochrane Database Sys Rev 18(4):CD004958 Jacobs WCH, Anderson PG, Van Limbeek J, Willems PC, Pavlov P (2004) Single or double-level anterior interbody fusion techniques for cervical degenerative disc disease. Cochrane Database Sys Rev 18(4):CD004958
7.
Zurück zum Zitat Johnson MG, Fisher CG, Boyd M, Pitzen T, Oxland TR, Dvorak MF (2004) The radiographic failure of single segment anterior cervical plate fixation in traumatic cervical flexion distraction injuries. Spine 29(24):2815–2820PubMedCrossRef Johnson MG, Fisher CG, Boyd M, Pitzen T, Oxland TR, Dvorak MF (2004) The radiographic failure of single segment anterior cervical plate fixation in traumatic cervical flexion distraction injuries. Spine 29(24):2815–2820PubMedCrossRef
8.
Zurück zum Zitat Troyanovich SJ, Stroink AR, Kattner KA, Dornan WA, Gubina I (2002) Does anterior plating maintain cervical lordosis versus conventional fusion techniques? A retrospective analysis of patients receiving single-level fusions. J Spinal Disord Tech 15:69–74PubMedCrossRef Troyanovich SJ, Stroink AR, Kattner KA, Dornan WA, Gubina I (2002) Does anterior plating maintain cervical lordosis versus conventional fusion techniques? A retrospective analysis of patients receiving single-level fusions. J Spinal Disord Tech 15:69–74PubMedCrossRef
9.
Zurück zum Zitat Kaiser MG, Haid RW, Subach BR, Barnes B, Rodts GE (2002) Anterior cervical plating enhances arthrodesis after discectomy and fusion with cortical allograft. Neurosurgery 50:229–236PubMed Kaiser MG, Haid RW, Subach BR, Barnes B, Rodts GE (2002) Anterior cervical plating enhances arthrodesis after discectomy and fusion with cortical allograft. Neurosurgery 50:229–236PubMed
10.
Zurück zum Zitat Yue WM, Brodner W, Highland TR (2005) Long-term results after ACDF with allograft and plating: a 5- to 11-year radiologic and clinical follow-up study. Spine 30(19):2138–2144PubMedCrossRef Yue WM, Brodner W, Highland TR (2005) Long-term results after ACDF with allograft and plating: a 5- to 11-year radiologic and clinical follow-up study. Spine 30(19):2138–2144PubMedCrossRef
11.
Zurück zum Zitat Hamburger C, Festenberg FV, Uhl E (2001) Ventral discectomy with PMMA interbody fusion for cervical-disc-disease: long-term results in 249 patients. Spine 26(3):249–255PubMedCrossRef Hamburger C, Festenberg FV, Uhl E (2001) Ventral discectomy with PMMA interbody fusion for cervical-disc-disease: long-term results in 249 patients. Spine 26(3):249–255PubMedCrossRef
12.
Zurück zum Zitat van den Bent MJ, Oosting J, Wouda EJ, van Acker RE, Ansink BJ, Braakman R (1996) Anterior cervical discectomy with or without fusion with acrylate. A randomized trial. Spine 21(7):834–840PubMedCrossRef van den Bent MJ, Oosting J, Wouda EJ, van Acker RE, Ansink BJ, Braakman R (1996) Anterior cervical discectomy with or without fusion with acrylate. A randomized trial. Spine 21(7):834–840PubMedCrossRef
13.
Zurück zum Zitat Ibanez J, Carreno A, Garcia-Amorena C, Caral J, Gaston F, Ferrer E (1998) Results of the BOP as an intersomatic graft in anterior cervical surgery. Acta Neurochir (Wien) 140(2):126–133CrossRef Ibanez J, Carreno A, Garcia-Amorena C, Caral J, Gaston F, Ferrer E (1998) Results of the BOP as an intersomatic graft in anterior cervical surgery. Acta Neurochir (Wien) 140(2):126–133CrossRef
14.
Zurück zum Zitat Hafez RF, Crockard HA (1997) Failure of osseous conduction with cervical interbody BOP graft. Br J Neurosurg 11(1):57–59PubMedCrossRef Hafez RF, Crockard HA (1997) Failure of osseous conduction with cervical interbody BOP graft. Br J Neurosurg 11(1):57–59PubMedCrossRef
15.
Zurück zum Zitat Vavruch L, Hedlund R, Javid D, Leszniewski W, Shalabi A (2002) A prospective randomized comparison between the Cloward procedure and a carbon fibre cage in the cervical spine: a clinical and radiologic study. Spine 27(16):1694–1701PubMedCrossRef Vavruch L, Hedlund R, Javid D, Leszniewski W, Shalabi A (2002) A prospective randomized comparison between the Cloward procedure and a carbon fibre cage in the cervical spine: a clinical and radiologic study. Spine 27(16):1694–1701PubMedCrossRef
16.
Zurück zum Zitat Lippman CR, Hajjar M, Abshire B, Martin G, Engelman RW, Cahill DW (2004) Cervical spine fusion with bioabsorbable cages. Neurosurg Focus 16(3):1–10CrossRef Lippman CR, Hajjar M, Abshire B, Martin G, Engelman RW, Cahill DW (2004) Cervical spine fusion with bioabsorbable cages. Neurosurg Focus 16(3):1–10CrossRef
17.
Zurück zum Zitat Eysel P, Fürderer S, Rompe JD, Zöllner J (2000) Die Primärstabilität unterschiedlicher Cages zur Fusion an der Halswirbelsäule. Zentralbl Neurochir 61(4):171–176PubMedCrossRef Eysel P, Fürderer S, Rompe JD, Zöllner J (2000) Die Primärstabilität unterschiedlicher Cages zur Fusion an der Halswirbelsäule. Zentralbl Neurochir 61(4):171–176PubMedCrossRef
18.
Zurück zum Zitat Bartels RH, Donk R, van Azn RD (2001) Height of cervical foramina after anterior discectomy and implantation of a carbon fiber cage. J Neurosurg 95(1Suppl):40–42PubMed Bartels RH, Donk R, van Azn RD (2001) Height of cervical foramina after anterior discectomy and implantation of a carbon fiber cage. J Neurosurg 95(1Suppl):40–42PubMed
19.
Zurück zum Zitat Thomé C, Leheta O, Krauss JK, Zevgaridis D (2006) A prospective randomized comparison of rectangular titanium cage fusion and iliac crest autograft fusion in patients undergoing anterior cervical discectomy. J Neurosurg Spine 4(1):1–9PubMedCrossRef Thomé C, Leheta O, Krauss JK, Zevgaridis D (2006) A prospective randomized comparison of rectangular titanium cage fusion and iliac crest autograft fusion in patients undergoing anterior cervical discectomy. J Neurosurg Spine 4(1):1–9PubMedCrossRef
20.
Zurück zum Zitat Wang MY, Liu CY (2005) Resorbable polylactic acid interbody spacers with vertebral autograft for ACDF. Neurosurgery 57(1):135–140PubMedCrossRef Wang MY, Liu CY (2005) Resorbable polylactic acid interbody spacers with vertebral autograft for ACDF. Neurosurgery 57(1):135–140PubMedCrossRef
21.
Zurück zum Zitat Aebi M, Zuber K, Marchesi D (1991) Treatment of cervical spine injuries with anterior plating. Indications, techniques, and results. Spine 16(3Suppl):S38–S45PubMedCrossRef Aebi M, Zuber K, Marchesi D (1991) Treatment of cervical spine injuries with anterior plating. Indications, techniques, and results. Spine 16(3Suppl):S38–S45PubMedCrossRef
22.
Zurück zum Zitat Darrel SB, Klimo P Jr, Kent NB, Braun JT, Dailey AT (2006) Anterior cervical fixation: analysis of load-sharing and stability with use of static and dynamic plates. J Bone Joint Surg (AM) 88-A:1566–1573 Darrel SB, Klimo P Jr, Kent NB, Braun JT, Dailey AT (2006) Anterior cervical fixation: analysis of load-sharing and stability with use of static and dynamic plates. J Bone Joint Surg (AM) 88-A:1566–1573
23.
Zurück zum Zitat Odom GL, Finney W, Woodhall B (1958) Cervical disk lesions. J Am Med Assn 166:23–28CrossRef Odom GL, Finney W, Woodhall B (1958) Cervical disk lesions. J Am Med Assn 166:23–28CrossRef
24.
Zurück zum Zitat White AA, Southwick WO, Deponte RJ, Gainor JW, Hardy R (1973) Relief of pain by anterior cervical-spine fusion for spondylosis. A report of 65 patients. J Bone Joint Surg (Am) 55-A:525–534 White AA, Southwick WO, Deponte RJ, Gainor JW, Hardy R (1973) Relief of pain by anterior cervical-spine fusion for spondylosis. A report of 65 patients. J Bone Joint Surg (Am) 55-A:525–534
25.
Zurück zum Zitat Emery SE, Fisher RS, Bohlman HH (1997) Three-level ACDF; radiographic and clinical results. Spine 22(22):2622–2625PubMedCrossRef Emery SE, Fisher RS, Bohlman HH (1997) Three-level ACDF; radiographic and clinical results. Spine 22(22):2622–2625PubMedCrossRef
26.
Zurück zum Zitat Kuhns CA, Geck MJ, Wang JC, Delamarter RB (2005) An outcomes analysis of the treatment of cervical pseudoarthrosis with posterior fusion. Spine 30(21):2424–2429PubMedCrossRef Kuhns CA, Geck MJ, Wang JC, Delamarter RB (2005) An outcomes analysis of the treatment of cervical pseudoarthrosis with posterior fusion. Spine 30(21):2424–2429PubMedCrossRef
27.
Zurück zum Zitat Hipp JA, Reitman CA, Wharton N (2005) Defining pseudoarthrosis in the cervical spine with differing motion thresholds. Spine 30(2):209–210PubMedCrossRef Hipp JA, Reitman CA, Wharton N (2005) Defining pseudoarthrosis in the cervical spine with differing motion thresholds. Spine 30(2):209–210PubMedCrossRef
28.
Zurück zum Zitat Hacker RJ, Cauthen JC, Gilbert TJ, Griffith SL (2000) A prospective randomized multicenter clinical evaluation of an anterior cervical fusion cage. Spine 25(20):2646–2655PubMedCrossRef Hacker RJ, Cauthen JC, Gilbert TJ, Griffith SL (2000) A prospective randomized multicenter clinical evaluation of an anterior cervical fusion cage. Spine 25(20):2646–2655PubMedCrossRef
29.
Zurück zum Zitat Anderson DG, Albert TJ (2002) Bone grafting, implants, and plating options for anterior cervical fusions. Orthop Clin North Am 33(2):317–328PubMedCrossRef Anderson DG, Albert TJ (2002) Bone grafting, implants, and plating options for anterior cervical fusions. Orthop Clin North Am 33(2):317–328PubMedCrossRef
30.
Zurück zum Zitat Barsa P, Suchomel P (2007) Factors affecting sagittal malalignment due to cage subsidence in stand-alone cage assisted anterior cervical fusion. Eur Spine J 16:1395–1400PubMedCentralPubMedCrossRef Barsa P, Suchomel P (2007) Factors affecting sagittal malalignment due to cage subsidence in stand-alone cage assisted anterior cervical fusion. Eur Spine J 16:1395–1400PubMedCentralPubMedCrossRef
Metadaten
Titel
Results of ACDF using Alexandria Modular Cage-Plate Construct in cervical canal stenosis
verfasst von
Ahmed Ezzat Siam
Hesham El Saghir
Tarek El-Fiky
Osama Moustafa
Yasser El Mansy
Publikationsdatum
01.06.2014
Verlag
Springer Berlin Heidelberg
Erschienen in
European Orthopaedics and Traumatology / Ausgabe 2/2014
Print ISSN: 1867-4569
Elektronische ISSN: 1867-4577
DOI
https://doi.org/10.1007/s12570-013-0208-0

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