Long-Term Follow-Up Results of Anterior Cervical Inter-Body Fusion with Stand-Alone Cages.
10.3340/jkns.2016.59.4.385
- Author:
Woong Beom KIM
1
;
Seung Jae HYUN
;
Hoyong CHOI
;
Ki Jeong KIM
;
Tae Ahn JAHNG
;
Hyun Jib KIM
Author Information
1. Department of Neurosurgery, Spine Center, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea. hyunsj@snu.ac.kr
- Publication Type:Original Article
- Keywords:
Anterior cervical discectomy and fusion;
Stand-alone cage;
Subsidence;
Long-term outcomes;
Intervertebral height;
Odom's criteria
- MeSH:
Arm;
Decision Making;
Diskectomy;
Follow-Up Studies*;
Humans;
Male;
Neck;
Retrospective Studies
- From:Journal of Korean Neurosurgical Society
2016;59(4):385-391
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: The purpose of this study was to evaluate long-term follow-up radiologic/clinical outcomes of patients who underwent anterior cervical discectomy and inter-body fusion (ACDF) with stand-alone cages (SAC) in a single academic institution. METHODS: Total 99 patients who underwent ACDF with SAC between February 2004 and December 2012 were evaluated retrospectively. A total of 131 segments were enrolled in this study. Basic demographic information, radiographic [segmental subsidence rate, fusion rate, C2-7 global angle, and segmental angle changes)/clinical outcomes (by Odom's criteria and visual analog score (VAS)] and complications were evaluated to determine the long-term outcomes. RESULTS: The majority were males (55 vs. 44) with average age of 53.2. Mean follow-up period was 62.9 months. The segmental subsidence rate was 53.4% and fusion rate was 73.3%. In the subsidence group, anterior intervertebral height (AIH) had more tendency of subsiding than middle or posterior intervertebral height (p=0.01). The segmental angle led kyphotic change related to the subsidence of the AIH. Adjacent segmental disease was occurred in 18 (18.2%) patients. Total 6 (6%) reoperations were performed at the index level. There was no statistical significance between clinical and radiological outcomes. But, overall long-term clinical outcome by Odom's criteria was unsatisfactory (64.64%). The neck and arm VAS score were increased by over time. CONCLUSION: Long-term outcomes of ACDF with SAC group were acceptable but not satisfactory. For optimal decision making, more additional comparative long-term outcome data is needed between ACDF with SAC and ACDF with plating.
