Long term outcome and adjacent disc degeneration after anterior cervical discectomy and fusion with titanium cylindrical cages.
BACKGROUND
Anterior cervical discectomy and fusion (ACDF) is widely performed for the treatment of cervical spinal degenerative disease. Autogenic or allogenic bone grafts are used for interbody fusion with satisfactory long term outcomes. However, harvest of the autograft causes donor site complications and allograft is associated with low fusion rate. Threaded titanium cages (TC) have recently been introduced to cope with these disadvantages, but there is little evidence of long term results.


METHODS
The long term outcome was studied after ACDF using TC. Clinical and imaging follow up was performed in 41 patients for at least 5 years (range 5-8.3 years). New computer-assisted measurement methods for radiographs are proposed.


RESULTS
ACDF with TC achieved 80% excellent or good outcome by Odom's criteria, 95% fusion rate, and few minor complications. Asymptomatic adjacent disc degeneration was detected in 50% of the patients by our measurement methods. However, symptomatic adjacent disc degeneration occurred in 5% of the patients and only 2% required additional surgery.


CONCLUSIONS
These results are comparable or better than those after ACDF with autograft or allograft. ACDF with TC can achieve rigid fixation and provide good long term results.
Sugawara
Taku
T
Department of Neurosurgery, School of Medicine, Akita University, Akita, Japan. taku@nsg.med.akita-u.ac.jp
Itoh
Yasunobu
Y
Hirano
Yoshitaka
Y
Higashiyama
Naoki
N
Mizoi
Kazuo
K
D000328:Adult; D000368:Aged; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D017586:Diskectomy / Q000009:adverse effects* / Q000295:instrumentation / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D016268:Internal Fixators / Q000009:adverse effects* / Q000706:statistics & numerical data; D007405:Intervertebral Disc Displacement / Q000453:epidemiology* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011182:Postoperative Care / Q000379:methods; D011183:Postoperative Complications / Q000453:epidemiology; D011859:Radiography; D011871:Radiology / Q000379:methods; D012189:Retrospective Studies; D055502:Secondary Prevention; D013123:Spinal Fusion / Q000009:adverse effects* / Q000295:instrumentation / Q000706:statistics & numerical data; D013995:Time; D014025:Titanium / Q000627:therapeutic use; D016896:Treatment Outcome
D014025:Titanium