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Two-level anterior cervical discectomy and fusion using self-locking stand-alone polyetheretherketone cages with two anchoring clips placed in the upper and lower vertebrae, respectively

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European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Background

Anterior cervical discectomy and fusion (ACDF) is a widely accepted surgical procedure for the treatment of cervical degenerative disk diseases (CDDD). The purpose of our study was to investigate the reliability and efficacy of ACDF using self-locking stand-alone polyetheretherketone (PEEK) cages, with two anchoring clips placed in the upper and lower vertebrae, respectively.

Methods and materials

Twenty-six patients who underwent ACDF using a stand-alone PEEK cage packed with local osteophytes and cancellous allograft bone from January 2010 to January 2012 were enrolled in this study. Clinical findings were assessed using a visual analog scale (VAS), Japanese Orthopaedic Association (JOA) score, neck disability index (NDI), and Odom criteria. Intervertebral height and cervical fusion status were assessed on X-ray.

Results

Twenty-six patients underwent ACDF using a stand-alone PEEK cervical cage. All patients had a minimum 2 years of follow-up. The operative levels were C3/4, C4/5 in seven patients, C4/5, C5/6 in 13 patients, and C4/5, C6/7 in six patients. At 3 days, 6 months, and 2 years of follow-ups, the JOA scores were 10.41 ± 1.67, 13.78 ± 1.91, 14.42 ± 2.09, respectively, which was significantly higher (p < 0.01) than preoperative (7.34 ± 1.71), whereas VAS overall pain score was 4.35 ± 1.32, 1.73 ± 0.44, 1.32 ± 0.57, respectively, which was significantly lower (p < 0.01) than preoperative (8.01 ± 1.16). The NDI preoperatively was 33.94 ± 11.75, 23.53 ± 10.92 at 3 days postoperatively, 12.64 ± 8.36 at 6 months, and 10.74 ± 7.92 at 2 years of follow-ups. Intervertebral height was 5.99 ± 0.31 mm preoperatively, 8.70 ± 0.23 mm at 3 days, 8.34 ± 0.61 mm at 6 months, and 8.22 ± 0.35 mm at 2 years of follow-ups. According to Odom criteria, 10 patients (38.4 %) presented with an excellent clinical outcome, 15 good (57.6 %), 1 fair (3.8 %), and no patient presented a poor outcome. Solid fusion was achieved in all patients (100 %) at a mean time of 4.5 months.

Conclusion

ACDF using a self-locking stand-alone PEEK cage with two anchoring clips placed in the upper and lower vertebrae, respectively, could be considered a safe and effective substitute for fusion in patients with two-level CDDD; it can effectively restore the intervertebral height, facilitate radiologic follow-up, cause few complications, and lead to satisfactory outcomes.

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Acknowledgments

The present study was financially supported by National Program on Key Basic Research Project (973 Program; Grant Number 2012CB619105).

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    Authors and Affiliations

    1. Department of Spine Surgery/Orthopaedic Research Institute, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510080, People’s Republic of China

      Jiaquan Luo, Sheng Huang, Ming Gong, Liangping Li, Ting Yu & Xuenong Zou

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    1. Jiaquan Luo
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    2. Sheng Huang
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    Correspondence to Jiaquan Luo or Xuenong Zou.

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    Jiaquan Luo and Sheng Huang have been contributed equally to this work.

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    Luo, J., Huang, S., Gong, M. et al. Two-level anterior cervical discectomy and fusion using self-locking stand-alone polyetheretherketone cages with two anchoring clips placed in the upper and lower vertebrae, respectively. Eur J Orthop Surg Traumatol 25 (Suppl 1), 147–153 (2015). https://doi.org/10.1007/s00590-015-1613-6

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