Subsidence after anterior cervical inter-body fusion. A randomized prospective clinical trial.
In ventral fusion after anterior cervical discectomy there is still a remarkable number of cage subsidence and segmental kyphosis seen. The aim of the present study is to assess whether the cage design influences the extent of correction loss during follow-up. Sixty patients with single-level cervical disc herniation were randomly treated with two different cervical inter-body cages (group 1: Solis cage, Stryker Company and group 2: Shell cage, AMT Company). Clinical and radiological follow-up was done before and after surgery, 3 and 6 months post-surgery. Clinical follow-up was done with the help of Odom's criteria. Both groups were similar in the baseline parameters (age, sex, treated level). Statistically, the subsidence was significantly higher at 3 and 6-month follow-ups in group 1 than in group 2, however, clinical results showed no significant differences. In 67%, subsidence was seen in the anterior lower aspect of the treated segment. Segmental kyphosis was seen in seven patients of group 1 and two patients of group 2. A significant correlation is found between Odom's criteria and subsidence. Although there was no significant difference in a short-term clinical result between the two treatment groups, we recommend the use of cages which preserve the determined segmental height and lordosis.
Kast
Erich
E
Department of Neurosurgery, Kantonsspital Winterthur, Brauerstrasse 15, CH-8401, Winterthur, Switzerland. erich.kast@ksw.ch
Derakhshani
Sharam
S
Bothmann
Matthias
M
Oberle
Joachim
J
D002574:Cervical Vertebrae / Q000601:surgery*; D017586:Diskectomy; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016268:Internal Fixators / Q000009:adverse effects*; D007738:Kyphosis / Q000175:diagnosis / Q000209:etiology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011859:Radiography; D013123:Spinal Fusion / Q000009:adverse effects*; D013131:Spine / Q000000981:diagnostic imaging / Q000473:pathology; D013997:Time Factors; D016896:Treatment Outcome
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