Anterior Cervical Pseudarthrosis Treated with Bilateral Posterior Cervical Cages
| Autor: | Veasna Vong, William D Smith, Mark Gillespy, Jason Huffman, Bruce M. McCormack |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Adult
Male medicine.medical_specialty Facet (geometry) Visual analogue scale Anterior cervical discectomy and fusion Disability Evaluation 03 medical and health sciences 0302 clinical medicine medicine Humans 030212 general & internal medicine Aged Pain Measurement Retrospective Studies Fixation (histology) business.industry Retrospective cohort study Perioperative Middle Aged medicine.disease Surgery Pseudarthrosis Spinal Fusion Treatment Outcome Radiological weapon Cervical Vertebrae Female Neurology (clinical) business 030217 neurology & neurosurgery |
| Zdroj: | Operative Neurosurgery. 14:236-242 |
| ISSN: | 2332-4260 2332-4252 |
| DOI: | 10.1093/ons/opx103 |
| Popis: | Background Pseudarthrosis after anterior cervical discectomy and fusion (ACDF) causes persistent pain and related disability. Posterior revision surgery results in higher healing rates, but is more extensive compared to anterior surgery. Objective To evaluate minimally disruptive, tissue sparing posterior fusion via bilateral placement of posterior cages between the facet joints as an alternative treatment option. Methods A retrospective, multicenter, medical chart review was performed and included 25 patients with symptomatic pseudarthrosis after ACDF treated with posterior cervical cages, and in select cases, anterior revision. Visual analog scale (VAS) for neck and arm pain, Neck Disability Index (NDI), and perioperative metrics were collected. Fusion at 1 yr was determined via assessment of computed tomography (CT) scan and x-rays. Results Mean follow-up was 18 mo. VAS neck and arm scores at last follow-up improved significantly from 7.9 ± 1.5 to 3.8 ± 2.3 and 7.24 ± 2.2 to 3.12 ± 2.5, respectively. NDI scores decreased from 65.1 ± 20.3 to 29.1 ± 17.9 at 18 mo. Fusion at 1 yr was confirmed by CT in all 17 patients with available scans and by x-ray in all 25 patients. Conclusion Revision of cervical pseudarthrosis after ACDF using a tissue sparing posterior approach to place cages bilaterally between the facet joints is an effective surgical strategy in select cases. Along with positive clinical and radiological outcomes, the procedure is associated with less blood loss, shorter operating times, and briefer hospital stays compared to revision with lateral mass fixation or interspinous wiring. |
| Databáze: | OpenAIRE |
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