Can multilevel standalone Cervical fusion replace multilevel plating in outpatient setting
4th International Conference on Spine and Spinal Disorders
September 03-04, 2019 | London, UK
Kingsley R Chin, Fabio J R Pencle and Jason A Seale
Less Exposure Surgery Specialists Institute (LESS Institute), USA Florida International University, USA Florida Atlantic University, USA University of Technology, USA Less Exposure Surgery (LES) Society, USA
Posters & Accepted Abstracts : J Neurol Neurorehabil Res
Abstract:
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 (ACDFCA),
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 oneyear
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 followup,
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.
Biography:
E-mail:
fabiopencle@thelessinstitute.comPDF HTML