Cervical spine stabilization by plate-cage. Clinical evaluation.
OBJECTIVE
Cervical plate-cages have recently been introduced to clinical practice. Clinical and radiographic results of D-Fun-CE plate-cage stabilization were studied.


METHODS
34 patients were treated surgically with the mean follow-up of 25 months. All cases were divided into 3 groups. Group 1 (n = 15) included posttraumatic cases after one-level discectomies, group 2 (n = 14) included patients with disc degenerative changes after one-level discectomies, and group 3 (n = 9) encompassed patients after two- and three-level discectomies. In the clinical evaluation ASIA scale, Odom's criteria and VAS scale were used. General and local cervical lordoses were assessed by Jackson's method. Subsidence was determined by modified Tye's method. Statistical significance of differences was assessed by Wilcoxon and Mann-Whitney tests.


RESULTS
At follow-up, 14 patients (93%) from group 1 improved at least by one degree on the ASIA scale. In Odom's criteria, 79% of patients in group 2 gained very good results, 14% good, and 7% satisfactory; but in group 3 only 56% of patients achieved very good, 22% good, and 22% satisfactory results. On the VAS scale, pain decreased from a mean of 6 to 1.4 after surgery and to 1.3 at follow-up. Overall averaged general cervical lordosis increased from 9.8 degrees before surgery to 19 degrees after surgery and to 19.2 degrees at follow-up. Local cervical lordosis changed from a mean of -2 degrees , to 9.8 degrees and 9.4 degrees , respectively. Subsidence in group 1 averaged 1.2 mm; in group 2, 0.6 mm; and in group 3, 2.4 mm.


CONCLUSIONS
The results indicate good stabilization properties of the D-Fun-CE plate-cage. All patients achieved spondylodesis, which is especially beneficial for multilevel cases. Subsidence was noted in the majority of operated cases (76.7% of patients) but its size increased together with the number of fused levels.
Hakalo
Jerzy
J
Department of Neurosurgery, Hospital of Nowa Sol, Poland. hakalo@poczta.onet.pl
Wronski
Jerzy
J
D000328:Adult; D000368:Aged; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016268:Internal Fixators; D008297:Male; D008875:Middle Aged; D011044:Poland; D011859:Radiography; D013123:Spinal Fusion / Q000295:instrumentation*; D013124:Spinal Injuries / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome