J Korean Orthop Assoc.  2016 Jun;51(3):191-198. 10.4055/jkoa.2016.51.3.191.

Usefulness of Anterior Cervical Interbody Fusion Using Locally Harvested Bone: Minimum 5-Year Follow-Up

• Shim DM
• Kim TK
• Oh SK
• Kuk SW
• Jang BJ
• Choi JW

• KMID: 2308579
• DOI: http://doi.org/10.4055/jkoa.2016.51.3.191

Abstract

PURPOSE
The purpose of this study is to determine the usefulness of locally harvested autobone as a filling material for fusion.
MATERIALS AND METHODS
Retrospective study was conducted for 21 patients diagnosed as cervical disc herniation with cervical myelopathy or radiculopathy who underwent anterior cervical fusion using locally harvested autobone and polyetheretherketone solis cage from June 2006 to September 2009, with a follow-up period of longer than 5 years. Radiologic outcomes were evaluated by the rate of bone union, the change of intervertebral height, and the subsidence of the cage.
RESULTS
In clinical results, visual analogue scale score was 5.8±0.71/7.7±0.78 at preoperative, 1.6±0.58/2.3±0.97 at 1-year follow-up, 1.8±0.81/2.7±1.28 at 5-year follow-up, and neck disability index score was 34.3±6.2 in preoperative stage, 6.25±3.21 at 1-year follow-up, and 6.51±4.05 at 5-year follow-up. Radiologically intervertebral height was reduced from average 6.31±0.93 mm in 1-year follow-up to average 6.22±0.85 mm in 5-year follow-up. Subsidence of cage was average 1.28±0.41 mm at 1-year follow-up and average 1.31±0.43 mm at 5-year follow-up, with no statistically significant difference (p>0.05). Average subsidence of cage in these cases was 3.25 mm. In postoperative complication, screw breakage occurred in 1 case, screw pull out occurred in 1 case, and there was no postoperative infection.
CONCLUSION
Using locally harvested autobone as filling material for fusion resulted in outstanding bone union and improvement of clinical results. In long term follow-up, there was no significant difference in union rate and complication incidence. Therefore use of locally harvested autobone as a filling material for fusion is considered an effective method.

Keyword

anterior cervical interbody fusion; locally harvested autobone graft; polyetheretherketone cage

MeSH Terms

Follow-Up Studies*
Humans
Incidence
Methods
Neck
Postoperative Complications
Radiculopathy
Retrospective Studies
Spinal Cord Diseases

Figure

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  Figure 1 Intra-operation finding.

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  Figure 2 Measurement of the radiographic outcome. (A) Lateral radiograph of the cervical spine showing subsidence distance. (B) Lateral radiograph of the cervical spine showing measurements of the segmental lordosis (SL). (C) Lateral radiograph of the cervical spine showing the segmental height measuring method.

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  Figure 3 Flexion-extension lateral X-ray changes in distance between spinous process less than 2 mm was determined as bone union.

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