Authors: Ahmad ElTantawy
Publish Date: 2015/02/24
Volume: 25, Issue: 1, Pages: 135-145
Abstract
Standalone cageassisted anterior cervical discectomy and fusion ACDF has proved to be safe and effective procedure for treatment of monosegmental cervical degenerative stenosis CDS However the success rate has reported to decline as the number of levels increases The aim of this prospective study was to evaluate the shortterm results of multilevel ACDF using standalone polyetheretherketone PEEK cagesTwentyeight patients 16 males and 12 females mean age 405 years of symptomatic multilevel CDS were enroled in this study and completed a 2year postoperative followup All patients underwent contiguous multilevel ACDF using indirect decompression and standalone PEEK cages between 2009 and 2012 Ten patients underwent twolevel fusions group I ten underwent threelevel fusions group II and eight underwent fourlevel fusions group III The visual analogue scales of neck and arm pain and Odom’s criteria were used to evaluate clinical outcomes Radiological evaluation was done to evaluate fusion cervical sagittal angle CSA and cage subsidenceThere was a statistical significant improvement in clinical parameters and radiological CSA values in all groups postoperatively This improvement was well maintained till final followup Subsidence and nonunion were encountered in seven and two fusion levels respectively with no significant differences between groups All patients were satisfied and none of them had major complications or required revision surgeryWith proper patient selection meticulous surgical technique and strict postoperative cervical bracing the lessinvasive indirect anterior cervical decompression technique augmented with standalone PEEK cageassisted ACDF is an efficient and safe method for the treatment of multilevel CDS
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