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Efficacy and Safety of an Absorbable Cervical Cage with and Without Plating: A Multicenter Case Study

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Biomechanics and Biomaterials in Orthopedics

Abstract

The objective of the present study is to evaluate the clinical results of a synthetic composite cervical cage (TCP/PLLA) in anterior cervical interbody fusion (ACF). The study subjects were 89 consecutive patients who underwent single or multi-level anterior cervical discectomy and fusion with a Duocage® (SBM, Lourdes, France) absorbable cage, with or without plate fixation. This case study shows that the fusion of the Duocage® is excellent with stables dynamic X-rays for 98.0 % of the operated levels, with a good resorption, and without any clinical inflammatory reaction, at latest follow-up. The functional results and the return to activities are also good. As well, this study confirms that patients with a fixation plate have better outcomes in terms of functional results and pain, when operated on several levels, and also in terms of migration and loss of disc height, whatever the number of operated levels.

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References

  1. Robinson RA, Smith GW. Anterolateral cervical disc removal and interbody fusion for cervical disc syndrome. Bull Johns Hopkins Hosp. 1955;96:223–4.

    Google Scholar 

  2. Smith GW, Robinson RA. The treatment of certain cervical-spine disorders by anterior removal of the intervertebral disc and interbody fusion. J Bone Joint Surg Am. 1958;40–A:3.

    Google Scholar 

  3. Cloward RB. The anterior approach for removal of ruptured cervical disks. J Neurosurg. 1958;15:602–17.

    Article  CAS  PubMed  Google Scholar 

  4. Bailey RW, Badgley CE. Stabilization of the cervical spine by anterior fusion. J Bone Joint Surg Am. 1960;42–A:565–94.

    PubMed  Google Scholar 

  5. Verbiest H. La chirurgie antérieure et latérale du rachis cervical. Neurochirurgie. 16(Suppl 2):1–212.

    Google Scholar 

  6. Flately TJ, Lynch KL, Benson M. Tissues responses to implants of calcium phosphate ceramic in the rabbit spine. Clin Orthop. 1983;179.

    Google Scholar 

  7. Nasca RJ, Lemons JE, Montgomery R. Evaluation of cryoconserved bone and synthetic biomaterials in promoting spinal fusion. Spine. 1991;16:330.

    Article  Google Scholar 

  8. Bucholz RW, Carlton A, Holmes RE. Hydroxyapatite and Tricalcium Phosphate bone graft substitutes. Orthop Clin North Am. 1987;18(2):323–34.

    CAS  PubMed  Google Scholar 

  9. Cazeau C, Doursounian L, Touzard RC. Utilisation de céramique de phosphate tricalcique dans la réparation des fractures du plateau tibial: résultats sur 10 cas revus à 2 ans. Enseignement de la SOFCOT; 1994.

    Google Scholar 

  10. Le Huec JC. Fractures articulaires récentes de l’extrémité supérieure du tibia de l’adulte. Conférences d’enseignement de la SOFCOT; 1996. p. 97–117.

    Google Scholar 

  11. Husson JL, Poncer R, Chatellier P, Morel G, Polar JL, Missoury F, Lancien G, Phosphates tricalciques et arthrodèses lombaires : résultats cliniques, radiographiques et histologiques. Enseignement de la SOFCOT; 1994.

    Google Scholar 

  12. Lantuejoul JP, Cambuzat A, Ray O, Clement D, Merloz P, Faure C, et Plaweski S. Utilisation du phosphate tricalcique comme substitut osseux: A propos d’une série de 55 cas. Compte-rendu du G.R.E.C.O. Rev de Chir Orthop. 1995;82:175.

    Google Scholar 

  13. Le Huec JC, Lesprit E, Delavigne D, Clement D, Chauveaux D, Le Rebeller A. Tri-calcium phosphate ceramics and allografts as bone substitutes for spinal fusion in idiopathic scioliosis : comparative clinical results at four years. Acta Orthop Belg. 1997;63:3.

    Google Scholar 

  14. Robert R, Faure A, Bord E, Delecrin J, Szapiro J, Passuti N, Cervical interbody fusion by xenograft and ceramics in traumatology. 1996, 3rd European GICD Forum: problems of the cervical spine surgery. Barcelone, ESPAGNE. 21–23 avril. 1996, Communication orale.

    Google Scholar 

  15. Faure A, Raoul S, Bord E, Rebai R, Delecrin J, Passuti N, Robert R. Intérêt des xénogreffes et des céramiques dans la chirurgie du rachis cervical. Journée sur les substituts osseux synthétiques en chirurgie orthopédique, Clinique U.C.L. Mont-Godinne – Namur, BELGIQUE, 14 juin.1997 Communication orale.

    Google Scholar 

  16. Robert R, Raoul S, Bord E, Faure A, Delecrin J, Passuti N. Evaluation of xenograft and ceramics in cervical corporectomy and discectomy. International Forum on New Technologies in Advanced Spine Surgery, State of the Art 199, Bad Fussing, ALLEMAGNE. 23–25 mai 1997; Communication orale.

    Google Scholar 

  17. Robert R, Faure A, Bord E, Raoul S, Delecrin J, Passuti N. Surgical anatomy and techniques used in cervical spine surgery at the cervicothoracic junction. Advanced Spine Course. Kruger Park, AFRIQUE DU SUD. 19–22 juin 1997; Communication orale.

    Google Scholar 

  18. Faure A, Bord E, Delecrin J, Perrouin-Verbe B, Richard I, Mathe JF, Robert R, Utilisation de greffons hétérologues et céramiques dans le rachis cervical traumatique. XI ème Congrès National de la SOFFMERR. Limoges, 12–14 septembre 1996, Communication orale.

    Google Scholar 

  19. Robert R, Raoul S, Delecrin J, Bord E, Faure A, Passuti N. Anterior cervical surgery and fusion by Tricalcicphosphate (Biosorb). Preliminary study on 25 cases. 6th European Forum of GICD, Segmental Instrumentation in Spine Surgery: Long Term Follow-up and New Techniques, Nantes, 19–20 janvier 1998, Communication orale.

    Google Scholar 

  20. Aunoble S, Clement D, Frayssinet P, Harmand M-F, Le Huec J-C. Biological performance of a new β-TCP/PLLA composite material for applications in spine surgery : In vitro and in vivo studies. J Biomed Mater Res A. 2006;30749:1–7.

    Google Scholar 

  21. Pascal-Mousselard H, Daculsi G, Lazennec J-Y, Catonné Y, Saillant G. Les cages intervertébrales cervicales: analyse critique de la littérature. Maîtrise Orthopédique n°147 – octobre 2005.

    Google Scholar 

  22. Barsa P, Suchomel P. Factors affecting sagittal malalignment due to cage subsidence in standalone cage assisted anterior cervical fusion. Eur Spine J. 2007;16(9):1395–400. Epub 2007 Jan 13.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Bartels RH, Donk RD, Feuth T. Subsidence of stand-alone cervical carbon fiber cages. Neurosurgery. 2006;58(3):502–8; discussion 502 – 8.

    Article  PubMed  Google Scholar 

  24. Chen Y, Chen D, Guo Y, Wang X, Lu X, He Z, Yuan W. Subsidence of titanium mesh cage: a study based on 300 cases. J Spinal Disord Tech. 2008;21(7):489–92.

    Article  PubMed  Google Scholar 

  25. Cho DY, Lee WY, Sheu PC. Treatment of multilevel cervical fusion with cages. Surg Neurol. 2004;62(5):378–85; discussion 385 – 6.

    Article  PubMed  Google Scholar 

  26. Dai LY, Jiang LS. Anterior cervical fusion with interbody cage containing beta-tricalcium phosphateaugmented with plate fixation: a prospective randomized study with 2-year follow-up. Eur Spine J. 2008;17(5):698–705. Epub 2008 Feb 27.

    Article  PubMed  PubMed Central  Google Scholar 

  27. De Germay B, Dubois G, Clément D. Clinical results of cervical interbody fusion with hydroxylapatite. A retrospective study about 67 cases. Rachis. 2001:13(3).

    Google Scholar 

  28. Kast E, Derakhshani S, Bothmann M, Oberle J. Subsidence after anterior cervical inter-body fusion. A randomized prospective clinical trial. Neurosurg Rev. 2009;32(2):207–14; discussion 214. Epub 2008 Sep 17.

    Article  PubMed  Google Scholar 

  29. Kulkarni AG, Hee HT, Wong HK. Solis cage (PEEK) for anterior cervical fusion: preliminary radiological results with emphasis on fusion and subsidence. Spine J. 2007;7(2):205–9. Epub 2006 Nov 17.

    Article  PubMed  Google Scholar 

  30. Matgé G. Cervical cage fusion with 5 different implants: 250 cases. Acta Neurochir (Wien). 2002;144(6):539–49; discussion 550.

    Article  Google Scholar 

  31. Song KJ, Taghavi CE, Lee KB, Song JH, Eun JP. The Efficacy of Plate Construct Augmentation Versus Cage Alone in Anterior Cervical Fusion. Spine (Phila Pa 1976). 2009;34(26):2886–92.

    Article  Google Scholar 

  32. Debusscher F, Aunoble S, Alsawad Y, Clément D, Le Huec JC. Anterior cervical fusion with a bio-resorbable composite cage (beta TCP – PLLA): clinical and radiological results from a prospective study on 20 patients. Eur Spine J. 2009;18(9):1314–20.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  33. Song KJ, Taghavi CE, Hsu MS, Lee KB, Kim GH, Song JH. Plate augmentation in anterior cervical discectomy and fusion with cage for degenerative cervical spinal disorders. Eur Spine J. 2010;19(10):1677–83.

    Article  PubMed  PubMed Central  Google Scholar 

  34. Bansal S, Chauhan V, Sharma S, Maheshwari R, Juyal A, Raghuvanshi S. Evaluation of hydroxyapatite and beta-tricalcium phosphate mixed with bone marrow aspirate as a bone graft substitute for posterolateral spinal fusion. Indian J Orthop. 2009;43(3):234–9.

    Article  PubMed  PubMed Central  Google Scholar 

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Correspondence to Jean-Charles Le Huec MD, PhD .

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Boissiere, L., de Germay, B., Aunoble, S., Le Huec, JC. (2016). Efficacy and Safety of an Absorbable Cervical Cage with and Without Plating: A Multicenter Case Study. In: Poitout, D. (eds) Biomechanics and Biomaterials in Orthopedics. Springer, London. https://doi.org/10.1007/978-1-84882-664-9_34

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  • DOI: https://doi.org/10.1007/978-1-84882-664-9_34

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