title: Subsidence after anterior cervical inter-body fusion. A randomized prospective clinical trial.
abstract: 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.
authors.affiliation: Department of Neurosurgery, Kantonsspital Winterthur, Brauerstrasse 15, CH-8401, Winterthur, Switzerland. erich.kast@ksw.ch
authors.forename: Erich
authors.initials: E
authors.lastname: Kast
authors.forename: Sharam
authors.initials: S
authors.lastname: Derakhshani
authors.forename: Matthias
authors.initials: M
authors.lastname: Bothmann
authors.forename: Joachim
authors.initials: J
authors.lastname: Oberle
mesh_terms: 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
references.citation: J Neurosurg. 1958 Nov;15(6):602-17
references.pmid: 13599052
references.citation: Br J Neurosurg. 2001 Aug;15(4):319-23
references.pmid: 11599447
references.citation: Spine J. 2005 Nov-Dec;5(6):645-9; discussion 649
references.pmid: 16291105
references.citation: Neurosurg Focus. 2002 Jan 15;12(1):E4
references.pmid: 16212331
references.citation: Neurosurg Focus. 2001 Apr 15;10(4):E8
references.pmid: 16732635
references.citation: J Neurosurg Spine. 2005 Feb;2(2):116-22
references.pmid: 15739521
references.citation: Zentralbl Neurochir. 2005 Feb;66(1):24-33; discussion 34
references.pmid: 15744625
references.citation: J Neurosurg Spine. 2006 Jun;4(6):447-53
references.pmid: 16776355
references.citation: J Am Med Assoc. 1958 Jan 4;166(1):23-8
references.pmid: 13491305
references.citation: Acta Neurochir (Wien). 1988;90(3-4):127-35
references.pmid: 3354360
references.citation: J Bone Joint Surg Br. 2003 Sep;85(7):1019-25
references.pmid: 14516039
references.citation: Spine (Phila Pa 1976). 2003 Jan 15;28(2):134-9
references.pmid: 12544929
references.citation: Orthopade. 2004 Nov;33(11):1290-9
references.pmid: 15340803
references.citation: Spine (Phila Pa 1976). 2002 Aug 15;27(16):1694-701
references.pmid: 12195057
references.citation: Br J Neurosurg. 2005 Dec;19(6):469-74
references.pmid: 16574558
references.citation: Eur Spine J. 2001 Aug;10(4):320-4
references.pmid: 11563618
references.citation: Acta Neurochir (Wien). 2003 Jul;145(7):565-9; discussion 569-70
references.pmid: 12910399
references.citation: Acta Neurochir (Wien). 2006 Mar;148(3):307-12; discussion 312
references.pmid: 16341633
references.citation: J Spinal Disord Tech. 2005 Aug;18(4):304-8
references.pmid: 16021009
references.citation: J Outcome Meas. 2001-2002;5(1):798-818
references.pmid: 16320550
references.citation: Eur Spine J. 2006 Feb;15(2):157-64
references.pmid: 15980998
references.citation: Eur Spine J. 2003 Jun;12(3):274-80
references.pmid: 12687444
references.citation: J Neurosurg Spine. 2006 Apr;4(4):292-9
references.pmid: 16619675
references.citation: Spine (Phila Pa 1976). 2001 Feb 1;26(3):249-55
references.pmid: 11224860
references.citation: Neurosurgery. 2002 Mar;50(3):510-6; discussion 516-7
references.pmid: 11841718
references.citation: J Bone Joint Surg Am. 1958 Jun;40-A(3):607-24
references.pmid: 13539086