5 / 12
allied
academies
Page 39
Notes:
Journal of Neurology and Neurorehabilitation Research | Volume 4
September 03-04, 2019 | London, UK
Spine and Spinal Disorders
4
th
International Conference on
J Neurol Neurorehabil Res, Volume 4
Can multilevel standalone Cervical fusion replace multilevel plating in outpatient
setting
Kingsley R Chin
1,2,3,4
, Fabio J R Pencle
1,4,5
and
Jason A Seale
1,5
1
Less Exposure Surgery Specialists Institute (LESS Institute), USA
2
Florida International University, USA
3
Florida Atlantic University, USA
4
University of Technology, USA
5
Less Exposure Surgery (LES) Society, USA
Introduction:
Cervical fusion for degenerative disc disease
continues to be the standard method of treatment. Anterior
cervical discectomy and fusion (ACDF) and anterior cervical
corpectomy and fusion (ACCF) combined with the use of
of plates are well-known surgical treatments in patients
with two level anterior cervical disc diseases. Multi-level
ACDF methods can also be subdivided into several different
methods including ACDF using tricortical autograft and plate
fixation (ACDF-AP), ACDF using stand-alone cage (ACDF-
CA), and ACDF using cage and plate fixation (ACDF-CP). The
authors aim to demonstrate the use of standalone cages in
multilevel anterior cervical discectomy and fusion.
Methods:
Retrospective review of prospectively collected
data of 37 patients who had multilevel ACDF-CA compared
to a historical cohort of 32 patient with multilevel ACDF-CP.
Outcomes assessed where VAS scores, NDI and fusion rate.
Result:
Of the 37 patients in Group 1 (ACDF-CA), 67% were
female with the group’s mean age being 52.8+/- 8.9 years and
a mean BMI 30.6+/-7.1 kg/m2. Of the 32 patients in Group
2 (ACDF-CP), 78% were female with the group’s mean age
being 55.7+/- 7.6 years and a mean BMI 32.1+/-6.4 kg/m2.
No statistical differences in gender, age or BMI were found
between groups, p=0.843, 0.691 and 0.947 respectively.
The demographics are summarized in Table 1, including
pathological levels treated and chief complaints (indication
for operation).
There was no significance between preoperative VAS neck,
arm and NDI scores between Groups 1 and 2, p=0.520, 0.83
and 0.43 respectively. Analysis of follow-up at the one-year
period demonstrated that Group 1 mean preoperative VAS
neck scores improved from 8.5+/-1.3 to 0.8+/-0.1 at one-year
follow-up, p<0.001. Preoperative VAS arm scores improved
from 6.1+/-1.9 to 1.1+/- 0.7, p<0.001. Preoperative mean
NDI scores decreased from 33.6+/-3.7 to 11.6+/-1.3 at one-
year follow-up, p<0.001. Group 2 mean preoperative VAS
neck scores improved from 8.8+/-1.0 to 1.5+/-0.3 at one-year
follow-up, p=0.001. Preoperative VAS arm scores improved
from 6.7+/- 1.6 to 1.6+/-0.2, p<0.001. Preoperative mean
NDI reduced from 35.8+/-2.5 to 12.8+/-1.7 at 1-year follow-
up, p=0.001. 100% fusion was achieved in both groups with
group 1 demonstrating sentinel sign as early as 6 months
(Figure 1).
Conclusion:
Stand alone anterior cervical fusion is gaining
popularity with increase of less exposure techniques. This
study shows that multilevel ACDF-CA is a feasible technique
for outpatient cervical spine and can replace outpatient
cervical fusion with plates.
e
:
fabiopencle@thelessinstitute.com