Cellular allograft for multilevel stand-alone anterior cervical discectomy and fusion
| Autor: | Christopher C. Young, Abdullah H. Feroze, Margaret McGrath, John R. Williams, Alec W Gibson, Gabrielle A. White-Dzuro, Madeline E Greil, Christoph P. Hofstetter, Sananthan Sivakanthan |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Visual analogue scale medicine.medical_treatment Arthrodesis Anterior cervical discectomy and fusion 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine Degenerative disease Foraminotomy medicine Humans Retrospective Studies business.industry Retrospective cohort study General Medicine Middle Aged medicine.disease Allografts Surgery Pseudarthrosis Spinal Fusion Treatment Outcome Cohort Neurology (clinical) business 030217 neurology & neurosurgery Diskectomy Follow-Up Studies |
| Zdroj: | Neurosurgical focus. 50(6) |
| ISSN: | 1092-0684 |
| Popis: | OBJECTIVE Anterior cervical discectomy and fusion (ACDF) is the most common treatment for degenerative disease of the cervical spine. Given the high rate of pseudarthrosis in multilevel stand-alone ACDF, there is a need to explore the utility of novel grafting materials. In this study, the authors present a single-institution retrospective study of patients with multilevel degenerative spine disease who underwent multilevel stand-alone ACDF surgery with or without cellular allograft supplementation. METHODS In a prospectively collected database, 28 patients who underwent multilevel ACDF supplemented with cellular allograft (ViviGen) and 25 patients who underwent multilevel ACDF with decellularized allograft between 2014 and 2020 were identified. The primary outcome was radiographic fusion determined by a 1-year follow-up CT scan. Secondary outcomes included change in Neck Disability Index (NDI) scores and change in visual analog scale scores for neck and arm pain. RESULTS The study included 53 patients with a mean age of 53 ± 0.7 years who underwent multilevel stand-alone ACDF encompassing 2.6 ± 0.7 levels on average. Patient demographics were similar between the two cohorts. In the cellular allograft cohort, 2 patients experienced postoperative dysphagia that resolved by the 3-month follow-up. One patient developed cervical radiculopathy due to graft subsidence and required a posterior foraminotomy. At the 1-year CT, successful fusion was achieved in 92.9% (26/28) of patients who underwent ACDF supplemented with cellular allograft, compared with 84.0% (21/25) of patients who underwent ACDF without cellular allograft. The cellular allograft cohort experienced a significantly greater improvement in the mean postoperative NDI score (p < 0.05) compared with the other cohort. CONCLUSIONS Cellular allograft is a low-morbidity bone allograft option for ACDF. In this study, the authors determined favorable arthrodesis rates and functional outcomes in a complex patient cohort following multilevel stand-alone ACDF supplemented with cellular allograft. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|