The state of segmental kyphosis of operated segment after anterior subaxial cervical fusion using different types of stabilizing systems
DOI:
https://doi.org/10.25305/unj.123308Keywords:
cervical spine trauma, decompression and fusion surgery, type of lesion, fusion methodAbstract
Objective. To analyze the stability of anterior subaxial fusion in patients with various osteoligamentous lesions of the cervical spine with different types of stabilizing systems.
Materials and methods. We have performed the analysis of the X-ray data of 80 patients with traumatic lesion of the cervical spine. As a criterion for the fusion stability, the segmental kyphosis index of the operated segment was used. The patients were divided into 2 groups, depending on the type of implanted fusion system. Each group was divided into subgroups according to Argenson et al. cervical spine lesion classification. The follow-up included the period before surgery, intraoperative period, 3-5 days after surgery, 3, 6 and 12-18 months after surgical treatment.
Results. Our study revealed the statistically significant advantage of telescopic implant fusion system at a follow-up of 3 months for B and C Argenson type fractures. Starting from 6 months after the operation and further, with all types of lesion, the vertebral body replacement system provides greater stability in comparison with combination of the Mesh and ventral plate.
Conclusions. The usage of a telescopic vertebral body replacement implant provides maximum preservation of the achieved correction of the segmental kyphosis of operated segment in patients with different types of fractures.
References
1. Yadollahi M, Paydar S, Ghaem H, Ghorbani M, Mousavi SM, Taheri Akerdi A, Jalili E, Niakan MH, Khalili HA, Haghnegahdar A, Bolandparvaz S. Epidemiology of Cervical Spine Fractures. Trauma Mon. 2016 Mar 16;21(3):e33608. eCollection 2016 Jul. [CrossRef] [PubMed] [PubMed Central]
2. Passias PG, Poorman GW, Segreto FA, Jalai CM, Horn SR, Bortz CA, Vasquez-Montes D, Diebo BG, Vira S, Bono OJ, De La Garza-Ramos R, Moon JY, Wang C, Hirsch BP, Zhou PL, Gerling M, Koller H, Lafage V. Traumatic Fractures of the Cervical Spine: Analysis of Changes in Incidence, Cause, Concurrent Injuries, and Complications Among 488,262 Patients from 2005 to 2013. World Neurosurg. 2017 Nov 11. pii: S1878-8750(17)31930-7. [CrossRef] [PubMed]
3. Fredш HL, Bakken IJ, Lied B, Rшnning P, Helseth E. Incidence of traumatic cervical spine fractures in the Norwegian population: a national registry study. Scand J Trauma Resusc Emerg Med. 2014 Dec 18;22:78. [CrossRef] [PubMed] [PubMed Central]
4. Goldberg W, Mueller C, Panacek E, Tigges S, Hoffman JR, Mower WR; NEXUS Group. Distribution and patterns of blunt traumatic cervical spine injury. Ann Emerg Med. 2001 Jul;38(1):17-21. [CrossRef] [PubMed]
5. National Spinal Cord Injury Statistical Center. Spinal cord injury facts and figures at a glance. J Spinal Cord Med. 2010;33(4):439-40. [PubMed]
6. Oner C, Rajasekaran S, Chapman JR, Fehlings MG, Vaccaro AR, Schroeder GD, Sadiqi S, Harrop J. Spine Trauma-What Are the Current Controversies? J Orthop Trauma. 2017 Sep;31 Suppl 4:S1-S6. [CrossRef] [PubMed]
7. Feuchtbaum E, Buchowski J, Zebala L. Subaxial cervical spine trauma. Curr Rev Musculoskelet Med. 2016 Dec;9(4):496-504. Review. [CrossRef] [PubMed] [PubMed Central]
8. Nekhlopochin AS. Comparative Analysis of Structural Characteristics of Vertebral Body Replacement Implants for Anterior Fusion. Hirurgiв pozvonočnika. 2015;12(3):8-12. Russian. [CrossRef]
9. Waschke A, Kaczor S, Walter J, Duenisch P, Kalff R, Ewald C. Expandable titanium cages for anterior column cervical reconstruction and their effect on sagittal profile: a review of 48 cases. Acta Neurochir (Wien). 2013 May;155(5):801-7; discussion 807. [CrossRef] [PubMed]
10. Elder BD, Lo SF, Kosztowski TA, Goodwin CR, Lina IA, Locke JE, Witham TF. A systematic review of the use of expandable cages in the cervical spine. Neurosurg Rev. 2016 Jan;39(1):1-11; discussion 11.Review. [CrossRef] [PubMed]
11. Pekmezci M, Tang JA, Cheng L, Modak A, McClellan RT, Buckley JM, Ames CP. Comparison of expandable and fixed interbody cages in a human cadaver corpectomy model, part I: endplate force characteristics. J Neurosurg Spine. 2012 Oct;17(4):321-6. [CrossRef] [PubMed]
12. Cabraja M, Abbushi A, Kroppenstedt S, Woiciechowsky C. Cages with fixation wings versus cages plus plating for cervical reconstruction after corpectomy – is there any difference? Cent Eur Neurosurg. 2010 May;71(2):59-63. [CrossRef] [PubMed]
13. Silber JS, Lipetz JS, Hayes VM, Lonner BS. Measurement variability in the assessment of sagittal alignment of the cervical spine: a comparison of the gore and cobb methods. J Spinal Disord Tech. 2004 Aug;17(4):301-5. [CrossRef] [PubMed]
14. Argenson C, Peretti F, Ghabris A, Eude P, Lovet J, Hovorka I. Classification of lower cervical spine injuries. Eur J Orthop Surg Traumatol. 1997;7(4):215–229. [CrossRef]
15. Fisher CG, Dvorak MF, Leith J, Wing PC. Comparison of outcomes for unstable lower cervical flexion teardrop fractures managed with halo thoracic vest versus anterior corpectomy and plating. Spine (Phila Pa 1976). 2002 Jan 15;27(2):160-6. [CrossRef] [PubMed]
16. Andaluz N, Zuccarello M, Kuntz C. Long-term follow-up of cervical radiographic sagittal spinal alignment after 1- and 2-level cervical corpectomy for the treatment of spondylosis of the subaxial cervical spine causing radiculomyelopathy or myelopathy: a retrospective study. J Neurosurg Spine. 2012 Jan;16(1):2-7. [CrossRef] [PubMed]
17. Koller H, Reynolds J, Zenner J, Forstner R, Hempfing A, Maislinger I, Kolb K, Tauber M, Resch H, Mayer M, Hitzl W. Mid- to long-term outcome of instrumented anterior cervical fusion for subaxial injuries. Eur Spine J. 2009 May;18(5):630-53. [CrossRef] [PubMed] [PubMed Central]
18. Jack A, Hardy-St-Pierre G, Wilson M, Choy G, Fox R, Nataraj A. Anterior Surgical Fixation for Cervical Spine Flexion-Distraction Injuries. World Neurosurg. 2017 May;101:365-371. [CrossRef] [PubMed]
19. Grob D, Frauenfelder H, Mannion AF. The association between cervical spine curvature and neck pain. Eur Spine J. 2007 May;16(5):669-78. Epub 2006 Nov 18. [CrossRef] [PubMed] [PubMed Central]
20. Zhang Y, Li J, Li Y, Shen Y. Incidence and risk factors of poor clinical outcomes in patients with cervical kyphosis after cervical surgery for spinal cord injury. Ther Clin Risk Manag. 2017 Dec 8;13:1563-1568. [CrossRef] [PubMed] [PubMed Central]
21. Spivak JM, Bharam S, Chen D, Kummer FJ. Internal fixation of cervical trauma following corpectomy and reconstruction. The effects of posterior element injury. Bull Hosp Jt Dis. 2000;59(1):47-51. [CrossRef] [PubMed]
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