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Biomechanical comparison of anterior cervical fusion

Wei Tian, Kai Yan, Xiao Han, Jie Yu, Peihao Jin, Xiaoguang Han
STUDY DESIGN: Prospective non-randomized comparative study. OBJECTIVE: To compare the long-term clinical and radiographic results of cervical artificial disc replacement (CADR) and anterior cervical discectomy and fusion (ACDF), and to provide our evidence whether CADR could reduce adjacent segment degeneration (ASD). SUMMARY OF BACKGROUND DATA: CADR is widely used in spine surgery today. In spite of the short-term results of it having been ascertained, the long-term results are still under observation...
June 28, 2016: Clinical Spine Surgery
Andy Chien, Dar-Ming Lai, Shwu-Fen Wang, Wei-Li Hsu, Chih-Hsiu Cheng, Jaw-Lin Wang
STUDY DESIGN: A prospective, time series design. OBJECTIVE: The purpose of this study is two-fold: firstly, to investigate the impact of altered cervical alignment and range of motion (ROM) on patients' self-reported outcomes after anterior cervical discectomy and fusion (ACDF), and secondly, to comparatively differentiate the influence of single- and two-level ACDF on the cervical ROM and adjacent segmental kinematics up to 12-month postoperatively. SUMMARY OF BACKGROUND DATA: ACDF is one of the most commonly employed surgical interventions to treat degenerative disc disease...
August 1, 2016: Spine
Bastian Welke, Michael Schwarze, Christof Hurschler, Thorsten Book, Stephan Magdu, Dorothea Daentzer
PURPOSE AND METHODS: For the treatment of degenerative disc diseases of the cervical spine, anterior cervical discectomy and fusion (ACDF) still represents the standard procedure. However, long term clinical studies have shown a higher incidence of pathologies in the adjacent segments. As an alternative to spinal fusion, cervical total disc replacement (cTDR) or dynamically implants were increasingly used. This in vitro study analyzed the kinematics and intradiscal pressures in seven multi-segmental human cervical spine using hybrid multidirectional test method...
July 2016: European Spine Journal
George A C Mendes, Curtis A Dickman, Nestor G Rodriguez-Martinez, Samuel Kalb, Neil R Crawford, Volker K H Sonntag, Mark C Preul, Andrew S Little
OBJECT The primary disadvantage of the posterior cervical approach for atlantoaxial stabilization after odontoidectomy is that it is conducted as a second-stage procedure. The goal of the current study is to assess the surgical feasibility and biomechanical performance of an endoscopic endonasal surgical technique for C1-2 fixation that may eliminate the need for posterior fixation after odontoidectomy. METHODS The first step of the study was to perform endoscopic endonasal anatomical dissections of the craniovertebral junction in 10 silicone-injected fixed cadaveric heads to identify relevant anatomical landmarks...
May 2015: Journal of Neurosurgery. Spine
Heiko Koller, Werner Schmoelz, Juliane Zenner, Alexander Auffarth, Herbert Resch, Wolfgang Hitzl, Davud Malekzadeh, Lukas Ernstbrunner, Martina Blocher, Michael Mayer
INTRODUCTION: A high rate of complications in multilevel cervical surgery with corpectomies and anterior-only screw-and-plate stabilization is reported. A 360°-instrumentation improves construct stiffness and fusion rates, but adds the morbidity of a second approach. A novel ATS-technique (technique that used anterior transpedicular screw placement) was recently described, yet no study to date has analyzed its performance after fatigue loading. Accordingly, the authors performed an analysis of construct stiffness after fatigue testing of a cervical 2-level corpectomy model reconstructed using a novel anterior transpedicular screw-and-plate technique (ATS-group) in comparison to standard antero-posterior instrumentation (360°-group)...
December 2015: European Spine Journal
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
Dorothea Daentzer, Elmar Willbold, Katharina Kalla, Ivonne Bartsch, Waseem Masalha, Maximiliane Hallbaum, Christof Hurschler, Theresa Kauth, Daniel Kaltbeitzel, Christian Hopmann, Bastian Welke
STUDY DESIGN: An experimental study using a sheep cervical spine interbody fusion model. OBJECTIVE: First, to compare anterior cervical discectomy and fusion of an experimental bioabsorbable cage consisting of a magnesium alloy and a polymer (poly-ε-caprolactone, PCL) with an autologous tricortical iliac crest bone graft. Second, to determine the degradation kinetics of the cage, assess the 2 fusion devices for biomechanical stability, and determine their histological characteristics...
September 15, 2014: Spine
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
Kamran Aghayev, James J Doulgeris, Sabrina A Gonzalez-Blohm, Mohammed Eleraky, William E Lee, Frank D Vrionis
BACKGROUND: Common fusion techniques for cervical degenerative diseases include two-level anterior discectomy and fusion and one-level corpectomy and fusion. The aim of the study was to compare via in-vitro biomechanical testing the effects of a two-level anterior discectomy and fusion and a one-level corpectomy and fusion, with anterior plate reconstruction. METHODS: Seven fresh frozen human cadaveric spines (C3-T1) were dissected from posterior musculature, preserving the integrity of ligaments and intervertebral discs...
January 2014: Clinical Biomechanics
Jung Hwan Lee, Jin Sung Kim, June Ho Lee, Ewy Ryong Chung, Chan Shik Shim, Sang-Ho Lee
BACKGROUND CONTEXT: Although anterior cervical discectomy and fusion (ACDF) is an effective treatment option for patients with cervical disc herniation, it limits cervical range of motion, which sometimes causes discomfort and leads to biomechanical stress at neighboring segments. In contrast, cervical artificial disc replacement (ADR) is supposed to preserve normal cervical range of motion than ACDF. A biomechanical measurement is necessary to identify the advantages and clinical implications of ADR...
July 1, 2014: Spine Journal: Official Journal of the North American Spine Society
William J Beutler, Andrew L Clavenna, Manasa Gudipally, Mark Moldavsky, Saif Khalil
BACKGROUND CONTEXT: Adjacent level degeneration (ALD) has been reported as one of the long-term consequences of anterior discectomy and fusion despite its clinical success in treating cervical pathologies. Traditionally, ALD is treated by replacing the previously implanted plate with a longer plate, which can lead to postoperative complications. The biomechanics of SIP in the adjacent level has not been investigated. PURPOSE: To evaluate the multidirectional stability of a spacer with integrated plate (SIP) in comparison to a traditional spacer and plate (TSP)...
July 2012: Spine Journal: Official Journal of the North American Spine Society
Yang Liu, Yang Hou, Lili Yang, Huajiang Chen, Xinwei Wang, Xiaodong Wu, Rui Gao, Ce Wang, Wen Yuan
STUDY DESIGN: A retrospective comparative study was performed in patients with 3-level cervical spondylotic myelopathy (CSM). OBJECTIVE: To compare the clinical outcomes, radiological parameters, and complication incidence of 3 reconstructive techniques after the anterior decompression of multilevel CSM. SUMMARY OF BACKGROUND DATA: There has been growing interest in combination of anterior cervical discectomy and fusion (ACDF) and anterior cervical corpectomy and fusion (ACCF) for the treatment of multilevel CSM in recent years...
November 1, 2012: Spine
Matthias Setzer, Mohamed Eleraky, Wesley M Johnson, Kamran Aghayev, Nam D Tran, Frank D Vrionis
OBJECT: The objective of this study was to compare the stiffness and range of motion (ROM) of 4 cervical spine constructs and the intact condition. The 4 constructs consisted of 3-level anterior cervical discectomy with anterior plating, 1-level discectomy and 1-level corpectomy with anterior plating, 2-level corpectomy with anterior plating, and 2-level corpectomy with anterior plating and posterior fixation. METHODS: Eight human cadaveric fresh-frozen cervical spines from C2-T2 were used...
June 2012: Journal of Neurosurgery. Spine
P Vaněk, O Bradáč, K Saur
PURPOSE OF THE STUDY: The aim of this study was to compare the efficacy of anterior cervical microdiscectomy and fusion carried out using a newly designed interbody spacer with that of a standard cage plate construct in patients with symptomatic cervical spine spodylosis. The comparison was based on radiographic results and fusion rates. MATERIAL: A total number of 113 consecutive patients were enrolled in this prospective study between October 2008 and July 2009...
2011: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
Nathaniel R Ordway, Byeong Cheol Rim, Rong Tan, Rebecca Hickman, Amir H Fayyazi
Graft subsidence following anterior cervical reconstruction can result in the loss of sagittal balance and recurring foraminal stenosis. This study examined the implant-endplate interface using a cyclic fatigue loading protocol in an attempt to model the subsidence seen in vivo. The superior endplate from 30 cervical vertebrae (C3 to T1) were harvested and biomechanically tested in axial compression with one of three implants: Fibular allograft; titanium mesh cage packed with cancellous chips; and trabecular metal...
April 2012: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
Mozammil Hussain, Ahmad Nassr, Raghu N Natarajan, Howard S An, Gunnar B J Andersson
BACKGROUND CONTEXT: Multilevel corpectomy, with or without anterior instrumentation, has been associated with both graft and anterior screw-plate complications. The addition of posterior instrumentation after anterior fixation has been shown to increase the overall stiffness of fused segments and decrease the likelihood of instrumentation failure. Little biomechanical information exists for providing guidance in the selection of an appropriate instrumentation technique after a multilevel cervical corpectomy...
April 2011: Spine Journal: Official Journal of the North American Spine Society
Michael A Finn, Mical M Samuelson, Frank Bishop, Kent N Bachus, Darrel S Brodke
STUDY DESIGN: Biomechanical study. OBJECTIVE: To determine biomechanical forces exerted on intermediate and adjacent segments after two- or three-level fusion for treatment of noncontiguous levels. SUMMARY OF BACKGROUND DATA: Increased motion adjacent to fused spinal segments is postulated to be a driving force in adjacent segment degeneration. Occasionally, a patient requires treatment of noncontiguous levels on either side of a normal level...
March 15, 2011: Spine
Michael J Lee, Mark Dumonski, Frank M Phillips, Leonard I Voronov, Susan M Renner, Gerard Carandang, Robert M Havey, Avinash G Patwardhan
STUDY DESIGN: A cadaveric biomechanical study. OBJECTIVE: To investigate the biomechanical behavior of the cervical spine after cervical total disc replacement (TDR) adjacent to a fusion as compared to a two-level fusion. SUMMARY OF BACKGROUND DATA: There are concerns regarding the biomechanical effects of cervical fusion on the mobile motion segments. Although previous biomechanical studies have demonstrated that cervical disc replacement normalizes adjacent segment motion, there is a little information regarding the function of a cervical disc replacement adjacent to an anterior cervical decompression and fusion, a potentially common clinical application...
November 1, 2011: Spine
Tony Goldschlager, Peter Ghosh, Andrew Zannettino, Mark Williamson, Jeffrey Victor Rosenfeld, Silviu Itescu, Graham Jenkin
BACKGROUND: Rapid, reliable fusion is the goal in anterior cervical diskectomy and fusion. Iliac crest autograft has a high rate of donor-site morbidity. Alternatives such as bone graft substitutes lack osteoinductivity, and recombinant bone morphogenetic proteins risk life-threatening complications. Both allogeneic mesenchymal precursor cells (MPCs) and amnion derived epithelial cells (AECs) have osteogenic potential. OBJECTIVE: To compare for the first time the capacity of MPCs and AECs to promote osteogenesis in an ovine model...
April 2011: Neurosurgery
Daniel K Park, Eric L Lin, Frank M Phillips
STUDY DESIGN: Prospective, randomized trial. OBJECTIVE: To assess the in vivo kinematics of the cervical spine after cervical fusion and arthroplasty. SUMMARY OF BACKGROUND DATA: Compared with spinal fusion, disc replacement may impede the development of adjacent segment disease. To achieve this goal, any arthroplasty device should achieve desired spinal alignment while maintaining physiologic spinal motion at both the operated and surrounding motion segments...
April 20, 2011: Spine
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