Anterior cervical decompression and fusion accelerates adjacent segment degeneration: comparison with asymptomatic volunteers in a ten-year magnetic resonance imaging follow-up study.

Anterior cervical decompression and fusion accelerates adjacent segment degeneration: comparison with asymptomatic volunteers in a ten-year magnetic resonance imaging follow-up study.

Spine (Phila Pa 1976). 2010 Jan 1;35(1):36-43

Authors: Matsumoto M, Okada E, Ichihara D, Watanabe K, Chiba K, Toyama Y, Fujiwara H, Momoshima S, Nishiwaki Y, Iwanami A, Ikegami T, Takahata T, Hashimoto T

Prospective 10-year follow-up magnetic resonance imaging (MRI) study of patients who underwent anterior cervical decompression and fusion (ACDF) and healthy control subjects.

PMID: 20023606 [PubMed – indexed for MEDLINE]

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Radiological analysis of 37 segments in cervical spine implanted with a peek stand-alone device, with at least one year follow-up.

Radiological analysis of 37 segments in cervical spine implanted with a peek stand-alone device, with at least one year follow-up.

Br J Neurosurg. 2010 Dec;24(6):633-40

Authors: Dufour T, Huppert J, Louis C, Beaurain J, Stecken J, Aubourg L, Vila T

High incidence of subsidence in cervical stand-alone cages was reported in the literature.

PMID: 20632875 [PubMed – indexed for MEDLINE]

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Conventional versus digital radiographs for intraoperative cervical spine-level localization: a prospective time and cost analysis.

Conventional versus digital radiographs for intraoperative cervical spine-level localization: a prospective time and cost analysis.

Spine J. 2009 Dec;9(12):967-71

Authors: Steinmetz MP, Mroz TE, Krishnaney A, Modic M

In today’s health-care environment, operational efficiency is intrinsic to balancing the need for increased productivity driven by rising costs and potentially decreasing reimbursement. Other operational factors kept constant, decreasing the time for a procedure can be viewed as one marker for increased efficiency.

PMID: 19716345 [PubMed – indexed for MEDLINE]

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Plate augmentation in anterior cervical discectomy and fusion with cage for degenerative cervical spinal disorders.

Plate augmentation in anterior cervical discectomy and fusion with cage for degenerative cervical spinal disorders.

Eur Spine J. 2010 Oct;19(10):1677-83

Authors: Song KJ, Taghavi CE, Hsu MS, Lee KB, Kim GH, Song JH

Anterior cervical discectomy and fusion (ACDF) with cage alone (ACDF-C) is associated with a significant incidence of subsidence, local kyphosis, and migration. The use of concurrent plate augmentation may decrease the incidence of these complications while improving the fusion rate. The purpose of the study is to present our results with ACDF with cage and plate augmentation (ACDF-CPA) and to compare these results to previous reports of outcomes following ACDF-C. We evaluated the radiologic and clinical parameters of 83 patients (266 fusion sites) who had an ACDF-CPA between March 2002 and May 2006. Radiologic parameters included fusion rate, fusion time, fusion type, site of pseudoarthrosis and rate and degree of subsidence. Clinical parameters included complications and overall outcomes assessed with Robinson’s criteria; 79 of 83 patients showed bony fusion (95.1%) at last follow-up postoperatively, and there was no significant difference in fusion rate between the number of fusion levels. Type I (pseudoarthrosis) was noticed in 9 patients (12 fusion sites), type II in 14 (19 fusion sites), and type III in 60 (235 fusion sites). Five type I and all type II fusions converged into type III by the last follow-up; 76 of 83 patients (91.6%) experienced good clinical outcomes. Pseudoarthrosis occurred more commonly in more proximal locations, and the subsidence rate was significantly greater in two-level fusions when compared with single-level fusions (P = 0.046). There were four metal-related complications. Plate augmentation in one- or two-level anterior cervical fusions for degenerative cervical spine disorders may improve fusion rates and reduce subsidence and complication rates, resulting in improved clinical outcomes.

PMID: 20376680 [PubMed – in process]

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Comparison of inpatient vs. outpatient anterior cervical discectomy and fusion: a retrospective case series.

Comparison of inpatient vs. outpatient anterior cervical discectomy and fusion: a retrospective case series.

BMC Surg. 2009;9:3

Authors: Liu JT, Briner RP, Friedman JA

Spinal surgery is increasingly being done in the outpatient setting. We reviewed our experience with inpatient and outpatient single-level anterior cervical discectomy and fusion with plating (ACDF+P).

PMID: 19265540 [PubMed – indexed for MEDLINE]

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Choice of surgical approach for ossification of the posterior longitudinal ligament in combination with cervical disc hernia.

Choice of surgical approach for ossification of the posterior longitudinal ligament in combination with cervical disc hernia.

Eur Spine J. 2010 Mar;19(3):494-501

Authors: Yang HS, Chen DY, Lu XH, Yang LL, Yan WJ, Yuan W, Chen Y

Ossification of the posterior longitudinal ligament (OPLL) is a common spinal disorder that presents with or without cervical myelopathy. Furthermore, there is evidence suggesting that OPLL often coexists with cervical disc hernia (CDH), and that the latter is the more important compression factor. To raise the awareness of CDH in OPLL for spinal surgeons, we performed a retrospective study on 142 patients with radiologically proven OPLL who had received surgery between January 2004 and January 2008 in our hospital. Plain radiograph, three-dimensional computed tomography construction (3D CT), and magnetic resonance imaging (MRI) of the cervical spine were all performed. Twenty-six patients with obvious CDH (15 of segmental-type, nine of mixed-type, two of continuous-type) were selected via clinical and radiographic features, and intraoperative findings. By MRI, the most commonly involved level was C5/6, followed by C3/4, C4/5, and C6/7. The areas of greatest spinal cord compression were at the disc levels because of herniated cervical discs. Eight patients were decompressed via anterior cervical discectomy and fusion (ACDF), 13 patients via anterior cervical corpectomy and fusion (ACCF), and five patients via ACDF combined with posterior laminectomy and fusion. The outcomes were all favorable. In conclusion, surgeons should consider the potential for CDH when performing spinal cord decompression and deciding the surgical approach in patients presenting with OPLL.

PMID: 20012451 [PubMed – indexed for MEDLINE]

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Anterior cervical discectomy and fusion to treat cervical spondylosis with sympathetic symptoms.

Anterior cervical discectomy and fusion to treat cervical spondylosis with sympathetic symptoms.

J Spinal Disord Tech. 2011 Feb;24(1):11-4

Authors: Hong L, Kawaguchi Y

Retrospective study.

PMID: 20625322 [PubMed – indexed for MEDLINE]

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Cubital tunnel surgery in patients with cervical radiculopathy: double crush syndrome?

Cubital tunnel surgery in patients with cervical radiculopathy: double crush syndrome?

Neurosurg Rev. 2009 Oct;32(4):471-8

Authors: Galarza M, Gazzeri R, Gazzeri G, Zuccarello M, Taha J

To determine differences in clinical outcomes in patients harboring both cubital tunnel syndrome (CuTS) and cervical radiculopathy and the influence of the so-called double crush syndrome. Both procedures were performed in 24 patients, mean age 55 years; first group of 14 patients underwent CuTS surgery as a first procedure. Second group of 10 patients underwent anterior cervical discectomy and fusion (ACDF) then ulnar nerve release (UNR). Two patients underwent bilateral nerve surgery and six multiple cervical discectomies. Surgeries consisted in 26 nerve releases with associated external neurolysis in five, and 34 ACDF procedures, with plating in six. Clinical complaints (mean time 12 months) were sensory in 20 arms, with associated motor weakness and hypothenar atrophy involvement in another six. Electromyography changes were mild (two arms), moderate (16 arms), and severe (eight arms). Mean time of follow-up was 3 years (range 18 months-14 years). Clinical improvement was evidenced in 14 patients. Sensory nerve symptoms improved in 13 limbs in both groups and motor improvement was evident in three patients with UNR as first surgery. A comparative cohort of 20 patients with UNR but without cervical radiculopathy was studied to disclose outcome differences. Of these, 13 patients had clinical improvement. No differences were found among groups. In patients with double crush syndrome, factors that seemed to influence a poor CuTS outcome were evolution of symptoms longer than a year, history of multiple neuropathies or radiculopathies, and ACDF performed before UNR.

PMID: 19685252 [PubMed – indexed for MEDLINE]

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A unique device, the disc space-fitted distraction device, for anterior cervical discectomy and fusion: early clinical and radiological evaluation.

A unique device, the disc space-fitted distraction device, for anterior cervical discectomy and fusion: early clinical and radiological evaluation.

J Neurosurg Spine. 2010 Apr;12(4):342-6

Authors: Tani S, Nagashima H, Isoshima A, Akiyama M, Ohashi H, Tochigi S, Abe T

To perform interbody distraction and to obtain spinal curvature correction during anterior cervical discectomy and fusion (ACDF), the authors recently adopted a new stand-alone device, a disc space-fitted distraction device (DFDD). In this preliminary report the authors introduce this unique device and discuss some advantages in terms of short-term clinical and radiological evaluations.

PMID: 20367369 [PubMed – indexed for MEDLINE]

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Long term outcome and adjacent disc degeneration after anterior cervical discectomy and fusion with titanium cylindrical cages.

Long term outcome and adjacent disc degeneration after anterior cervical discectomy and fusion with titanium cylindrical cages.

Acta Neurochir (Wien). 2009 Apr;151(4):303-9; discussion 309

Authors: Sugawara T, Itoh Y, Hirano Y, Higashiyama N, Mizoi K

Anterior cervical discectomy and fusion (ACDF) is widely performed for the treatment of cervical spinal degenerative disease. Autogenic or allogenic bone grafts are used for interbody fusion with satisfactory long term outcomes. However, harvest of the autograft causes donor site complications and allograft is associated with low fusion rate. Threaded titanium cages (TC) have recently been introduced to cope with these disadvantages, but there is little evidence of long term results.

PMID: 19262984 [PubMed – indexed for MEDLINE]

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