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Stand alone anterior cervical interbody fusion

Daniel G Kang, Scott C Wagner, Robert W Tracey, John P Cody, Rachel E Gaume, Ronald A Lehman
STUDY DESIGN: In vitro human cadaveric biomechanical analysis. OBJECTIVE: To evaluate the segmental stability of a stand-alone spacer (SAS) device compared with the traditional anterior cervical plate (ACP) construct in the setting of a 2-level cervical fusion construct or as a hybrid construct adjacent to a previous 1-level ACP construct. METHODS: Twelve human cadaveric cervical spines (C2-T1) were nondestructively tested with a custom 6-degree-of-freedom spine simulator under axial rotation (AR), flexion-extension (FE), and lateral bending (LB) at 1...
October 2017: Global Spine Journal
Parmenion P Tsitsopoulos, Leonard I Voronov, Michael R Zindrick, Gerard Carandang, Robert M Havey, Alexander J Ghanayem, Avinash G Patwardhan
OBJECTIVE: To test the following hypotheses: (i) anterior cervical discetomy and fusion (ACDF) using stand-alone interbody spacers will significantly reduce the range of motion from intact spine; and (ii) the use of a static or a rotational-dynamic plate will significantly augment the stability of stand-alone interbody spacers, with similar beneficial effect when compared to each other. METHODS: Eleven human cadaveric subaxial cervical spines (age: 48.2 ± 5.4 years) were tested under the following sequence: (i) intact spine; (ii) ACDF at C4 -C5 using a stand-alone interbody spacer; (iii) ACDF at C5 -C6 and insertion of an interbody spacer (two-level construct); and (iv) randomized placement of either a two-level locking static plate or a rotational-dynamic plate...
August 2017: Orthopaedic Surgery
Shayan Abdollah Zadegan, Aidin Abedi, Seyed Behnam Jazayeri, Hirbod Nasiri Bonaki, Alexander R Vaccaro, Vafa Rahimi-Movaghar
STUDY DESIGN: Narrative review. OBJECTIVES: Anterior cervical discectomy and fusion (ACDF) is a reliable procedure, commonly used for cervical degenerative disc disease. For interbody fusions, autograft was the gold standard for decades; however, limited availability and donor site morbidities have led to a constant search for new materials. Clinically, it has been shown that calcium phosphate ceramics, including hydroxyapatite (HA) and tricalcium phosphate (TCP), are effective as osteoconductive materials and bone grafts...
June 2017: Global Spine Journal
Rui Feng, Joshua Loewenstern, John Caridi
BACKGROUND: Cervical stand-alone interbody cages have seen increasingly wider use over the plate-and-screw construct in single-level anterior cervical discectomy and fusion (ACDF) in the treatment of cervical disc herniation and degenerative spondylotic conditions. Despite positive clinical outcomes, the efficacy and safety of using these devices in contiguous multilevel ACDF has remained controversial. This report discusses a burst fracture seen as a complication in multilevel cervical stand-alone cage use...
September 2017: World Neurosurgery
Michael N Bucci, Dennis Oh, R Scott Cowan, Reginald J Davis, Robert J Jackson, Dwight S Tyndall, Daniel Nehls
INTRODUCTION: Anterior cervical discectomy and fusion (ACDF) has been the gold standard for treating cervical degenerative disc disease (cDDD). The use of anterior plates in ACDF poses an increased risk of complications such as screw or plate dislodgement, soft tissue injury, esophagus perforation, and dysphagia. The ROI-C™ implant system consists of a zero-profile interbody fusion cage with self-locking plates designed for stand-alone fusion without external plates or screws. OBJECTIVE: The purpose of this report is to describe the ROI-C™ implant system with VerteBRIDGE™ anchor plates, including indications for use, surgical technique, preclinical testing, and clinical study results...
2017: Medical Devices: Evidence and Research
Jae-Young Park, Ki-Young Choi, Bong Ju Moon, Hyuk Hur, Jae-Won Jang, Jung-Kil Lee
To investigate the risk factors for subsidence in patients treated with stand-alone anterior cervical discectomy and fusion (ACDF) using polyetheretherketone (PEEK) cages for single-level degenerative cervical disease. Seventy-seven consecutive patients who underwent single-level stand-alone ACDF with a PEEK cage between 2005 and 2012 were included. Subsidence was defined as a decrease in the interbody height of more than 3mm on radiographs at the 1-year follow-up compared with that in the immediate post-operative image...
November 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Ehsan Tabaraee, Junyoung Ahn, Daniel D Bohl, Michael J Collins, Dustin H Massel, Khaled Aboushaala, Kern Singh
STUDY DESIGN: Retrospective cohort analysis of a prospectively maintained registry. OBJECTIVE: To compare the surgical outcomes, narcotic utilization, and costs between a stand-alone (SA) cage and anterior plating (AP) with an interbody device for 1-level anterior cervical discectomy and fusion (ACDF). BACKGROUND DATA: ACDF with a SA cage has gained popularity as a potential alternative to anterior cervical plating. Few studies have compared the surgical outcomes, narcotic utilization, and costs of ACDF utilizing a SA cage versus AP with an interbody device...
July 14, 2016: Clinical Spine Surgery
Young-Seok Lee, Young-Baeg Kim, Seung-Won Park
STUDY DESIGN: Retrospective cohort study. OBJECTIVE: This study aimed to compare 3 different surgical methods of single-level anterior cervical interbody fusion consisting of stand-alone cages (SCs), cages with plates (CPs), and anchored cages (ACs) (zero-profile). It focused on postoperative retention and motion stabilization. SUMMARY OF BACKGROUND DATA: Several authors reported the radiological and clinical results of ACs, which seem similar to plates...
May 15, 2015: Spine
Chang-Hyun Lee, Ki-Jeong Kim, Seung-Jae Hyun, Jin S Yeom, Tae-Ahn Jahng, Hyun-Jib Kim
BACKGROUND: Subsidence is a frequent phenomenon in the interbody fusion process in patients with anterior cervical discectomy and fusion (ACDF). There is little evidence of whether subsidence in the cervical spine has any impact on clinical outcomes. OBJECTIVES: The purpose of this study is to investigate the correlation of subsidence and clinical outcomes after ACDF and to consider reasons subsidence might not cause unfavorable clinical outcomes. METHODS: A total of 158 consecutive patients who underwent single-level ACDF were included...
June 2015: Acta Neurochirurgica
Matti Scholz, Philipp Schleicher, Simone Pabst, Frank Kandziora
STUDY DESIGN: In vitro biomechanical analysis of different multilevel cervical fixation techniques. OBJECTIVE: To compare the multilevel stability of a cervical anchored spacer (AS) with established fixation techniques. SUMMARY OF BACKGROUND DATA: To avoid plate-related complications, for example, dysphagia zero-profile AS has been developed. The use of these new zero-profile implants for treatment of cervical degenerative disc disease is widely accepted after encouraging biomechanical results for single-level instrumentation...
April 1, 2015: Spine
Jae Sik Shin, Sung Han Oh, Pyoung Goo Cho
OBJECTIVE: A Zero-profile device is a cervical stand-alone cage with integrated segmental fixation device. We characteristically evaluated the radiological changes as well as clinical outcomes in the application of Zero-profile devices compared with stand-alone cages and anterior cervical plates with iliac bone grafts for the cervical disease. METHODS: Retrospectively, total 60 patients at least more than one year follow-up were enrolled. Twenty patients were treated with Zero-profile devices (Group A), twenty patients with stand-alone cages (Group B) and twenty patients with anterior cervical plates and iliac bone grafts (Group C) for a single level cervical disease...
September 2014: Korean Journal of Spine
Minwook Yoo, Wook-Ha Kim, Seung-Jae Hyun, Ki-Jeong Kim, Tae-Ahn Jahng, Hyun-Jib Kim
OBJECTIVE: The authors conducted a retrospective study to compare the implantation of carbon fiber composite frame cages (CFCFCs) to the implantation of polyetheretherketone (PEEK) cages after anterior cervical discectomy for cervical degenerative disc disease. In addition, the predictive factors that influenced fusion or subsidence were investigated. METHODS: A total of 58 patients with single-level degenerative disc disease were treated with anterior cervical discectomy and implantation of stand-alone cages; CFCFCs were used in 35 patients, and PEEK cages were used in 23 patients...
September 2014: Korean Journal of Spine
P Barsa, S Elgawhary, J Hradil, M Sercl, P Suchomel
PURPOSE OF THE STUDY: The original aim of this prospective semi-randomised study was to determine associations between segmental sagittal alignment after Anterior Cervical Discectomy and Fusion (ACDF) and subjective and clinical results. Two types of cages, cage P with parallel end-plates and cage A with 5-degree angulations, were used in the patients treated for degenerative conditions. MATERIAL AND METHODS: A total of 94 consecutive patients, 56 treated by single-level ACDF and 38 undergoing a two-level procedure, completed 8 years of follow-up...
2014: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
Innocent Njoku, Marjan Alimi, Lewis Z Leng, Benjamin J Shin, Andrew R James, Sandeep Bhangoo, Apostolos John Tsiouris, Roger Härtl
OBJECT: Anterior cervical plating decreases the risk of pseudarthrosis following anterior cervical discectomy and fusion (ACDF). Dysphagia is a common complication of ACDF, with the anterior plate implicated as a potential contributor. A zero-profile, stand-alone polyetheretherketone (PEEK) interbody spacer has been postulated to minimize soft-tissue irritation and postoperative dysphagia, but studies are limited. The object of the present study was to determine the clinical and radiological outcomes for patients who underwent ACDF using a zero-profile integrated plate and spacer device, with a focus on the course of postoperative prevertebral soft-tissue thickness and the incidence of dysphagia...
October 2014: Journal of Neurosurgery. Spine
Chi Heon Kim, Chun Kee Chung, Tae-Ahn Jahng, Sung Bae Park, Seil Sohn, Sungjoon Lee
STUDY DESIGN: Retrospective comparative study. OBJECTIVE: Two polyetheretherketone (PEEK) cages of different designs were compared in terms of the postoperative segmental kyphosis after anterior cervical discectomy and fusion. SUMMARY OF BACKGROUND DATA: Segmental kyphosis occasionally occurs after the use of a stand-alone cage for anterior cervical discectomy and fusion. Although PEEK material seems to have less risk of segmental kyphosis compared with other materials, the occurrence of segmental kyphosis for PEEK cages has been reported to be from 0% to 29%...
February 2015: Journal of Spinal Disorders & Techniques
Aniruddh N Nayak, Matthew I Stein, Chris R James, Roger B Gaskins, Andres F Cabezas, Maxwell Adu-Lartey, Antonio E Castellvi, Brandon G Santoni
BACKGROUND CONTEXT: Despite an increase in the clinical use of no-profile anchored interbody cages (AIC) for anterior cervical discectomy and fusion (ACDF) procedures, there is little published biomechanical data describing its stabilizing effect relative to the traditional anterior plating technique over two contiguous levels. PURPOSE: To biomechanically compare the acute stability conferred by a stand-alone interbody fusion device with three integrated fixation screws ("anchored cage") with a traditional six-hole rigid anterior plate in a two contiguous levels (C4-C5+C5-C6) fusion construct...
December 1, 2014: Spine Journal: Official Journal of the North American Spine Society
Carlo Brembilla, Luigi Andrea Lanterna, Paolo Gritti, Antonio Signorelli, Francesco Biroli
BACKGROUND: Anterior spinal surgery has a predominant role in the treatment of traumatic lesions of the subaxial cervical spine. Plating is considered indispensable to achieve stability but may cause dysphagia, dysphonia, and adjacent-level ossification. Zero-P (Synthes GmbH, Oberdorf, Switzerland), an anchored interdisc spacer, can be used without an associated plate. The present study aimed to test if this new implant would be associated with a low rate of dysphagia and other short-term complications compared with the standard for anterior spinal fusion surgery and would be able to achieve a solid fusion and maintain correct metamere alignment...
January 2015: Journal of Neurological Surgery. Part A, Central European Neurosurgery
Vivek Palepu, Ali Kiapour, Vijay K Goel, James M Moran
BACKGROUND: The efficacy of dynamic anterior cervical plates is somewhat controversial. Screws in static-plate designs have a smaller diameter and can cut through bone under load. While not ideal, this unintended loosening can help mitigate stress shielding. Stand-alone interbody devices with integral fixation have large endplate contact areas that may inhibit or prevent loosening of the fixation. This study investigates the load sharing ability of a novel dynamic plate design in preventing the stress shielding of the graft material compared to the non-dynamic devices...
2014: Biomedical Engineering Online
Haines Paik, Daniel G Kang, Ronald A Lehman, Mario J Cardoso, Rachel E Gaume, Divya V Ambati, Anton E Dmitriev
BACKGROUND CONTEXT: Some postoperative complications after anterior cervical fusions have been attributed to anterior cervical plate (ACP) profiles and the necessary wide operative exposure for their insertion. Consequently, low-profile stand-alone interbody spacers with integrated screws (SIS) have been developed. Although SIS constructs have demonstrated similar biomechanical stability to the ACP in single-level fusions, their role as a stand-alone device in multilevel reconstructions has not been thoroughly evaluated...
August 1, 2014: Spine Journal: Official Journal of the North American Spine Society
Jeong-Ill Park, Dae-Chul Cho, Kyoung-Tae Kim, Joo-Kyung Sung
OBJECTIVE: It remains debatable whether cervical spine fusion cages should be filled with any kind of bone or bone substitute. Cortical and subcortical bone from the anterior and posterior osteophytes of the segment could be used to fill the cage. The purposes of the present study are to evaluate the clinical outcomes and radiological outcomes including bone fusion and subsidence that occurred after anterior cervical discectomy and fusion using a stand-alone cage packed with local autobone graft...
September 2013: Journal of Korean Neurosurgical Society
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