title: A comparison between the carbon fiber cage and the cloward procedure in cervical spine surgery: a ten- to thirteen-year follow-up of a prospective randomized study.
abstract: METHODS
  Ten- to 13-year follow-up of a prospective randomized study.
  
  
  OBJECTIVE
  To compare the 10- to 13-year outcomes of anterior cervical decompression and fusion (ACDF) with a cervical intervertebral fusion cage (CIFC), and the Cloward procedure (CP) using a broad clinical and patient-centered assessment. SUMMARY OF BACKGROUND DATA.: There are few prospective studies and none with a follow-up of 10 years or more.
  
  
  METHODS
  Patient questionnaires completed 10 years or more after ACDF. Seventy-three patients (77%) responded. Radiographs were obtained at 2 years.
  
  
  RESULTS
  Apart from greater fulfillment of preoperative expectation (P = 0.01) and less headache (P = 0.005) in the CIFC group compared with the CP group, there were no significant differences in the outcomes of the two surgical methods. Pain intensity improved in comparison with preoperative levels in both the CIFC and CP groups (P < 0.0001), but the Neck Disability Index (NDI) only improved in the CIFC group (P = 0.04). Only those with a healed fusion benefited from an improved NDI (P = 0.02). There was no deterioration in pain intensity or NDI after the 2-year follow-up.
  
  
  CONCLUSIONS
  The outcomes of the two surgical methods, with a few exceptions, were equal at 10- to 13-year follow-up, and there was no deterioration in outcome after the 2-year follow-up. Pain intensity improved more than disability, which may indicate that further improvement of physical function requires early more extensive postoperative rehabilitation. Despite persisting disability, repeat surgery was relatively uncommon.
authors.affiliation: Department of Medical and Health Sciences, Division of Physiotherapy, Faculty of Health Sciences, Linköping University, Linköping, Sweden. Anneli.Peolsson@liu.se
authors.forename: Anna
authors.initials: A
authors.lastname: Hermansen
authors.forename: Rune
authors.initials: R
authors.lastname: Hedlund
authors.forename: Ludek
authors.initials: L
authors.lastname: Vavruch
authors.forename: Anneli
authors.initials: A
authors.lastname: Peolsson
mesh_terms: D000328:Adult; D000368:Aged; D001860:Bone Plates; D002244:Carbon; D000077482:Carbon Fiber; D002574:Cervical Vertebrae / Q000601:surgery*; D019299:Decompression, Surgical / Q000295:instrumentation / Q000639:trends*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016268:Internal Fixators; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement / Q000639:trends; D011446:Prospective Studies; D013123:Spinal Fusion / Q000295:instrumentation / Q000639:trends*; D016896:Treatment Outcome
chemical_list: D000077482:Carbon Fiber; D002244:Carbon