Volume : 6, Issue : 9, September - 2017

Outcome Analysis of Discectomy with Standalone Cage for Management of Cervical Disc Prolapse

Dr. K. Velmurugan, Dr. Hemanthakumar, Dr. M. Sathish

Abstract :

<p>&nbsp;<b><span lang="EN-IN" style="font-size:12.0pt;font-family:&quot;Candara&quot;,&quot;sans-serif&quot;;&#10;mso-bidi-font-family:Palatino-Roman">Background:&nbsp; </span></b><span lang="EN-IN" style="font-size: 12pt; font-family: Candara, sans-serif;">Anterior cervical decompression and fusion (ACDF) is the major treatment option in the management of cervical degenerative disease leading to persistent radiculopathy or myelopathy. The standalone cage was initiated by Bagby was used since 1988. To counteract the complications with the plating for anterior cervical discectomy and fusion (ADCF), standalone cage concept was developed and favourable outcomes have been described with a low rate of dysphagia.</span></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height:&#10;normal;mso-layout-grid-align:none;text-autospace:none"><span lang="EN-IN" style="font-size:12.0pt;font-family:&quot;Candara&quot;,&quot;sans-serif&quot;;mso-bidi-font-family:&#10;Palatino-Roman">&nbsp;</span></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height:&#10;normal;mso-layout-grid-align:none;text-autospace:none"><b><span lang="EN-IN" style="font-size:12.0pt;font-family:&quot;Candara&quot;,&quot;sans-serif&quot;;&#10;mso-bidi-font-family:Palatino-Roman">Objective:</span></b><span lang="EN-IN" style="font-size:12.0pt;font-family:&quot;Candara&quot;,&quot;sans-serif&quot;;mso-bidi-font-family:&#10;Palatino-Roman"> &nbsp;&nbsp;&nbsp;&nbsp;&nbsp; The purpose of this study is to evaluate radiological / clinical outcome of patients who underwent anterior cervical discectomy and fusion (ADCF) with standalone cages (SAC)&nbsp; <o:p></o:p></span></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height:&#10;normal;mso-layout-grid-align:none;text-autospace:none"><span lang="EN-IN" style="font-size:12.0pt;font-family:&quot;Candara&quot;,&quot;sans-serif&quot;;mso-bidi-font-family:&#10;Palatino-Roman">&nbsp;</span></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height:&#10;normal;mso-layout-grid-align:none;text-autospace:none"><b><span lang="EN-IN" style="font-size:12.0pt;font-family:&quot;Candara&quot;,&quot;sans-serif&quot;;&#10;mso-bidi-font-family:Palatino-Roman">Methods:</span></b><span lang="EN-IN" style="font-size:12.0pt;font-family:&quot;Candara&quot;,&quot;sans-serif&quot;;mso-bidi-font-family:&#10;Palatino-Roman"> &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Total 15 patients who underwent ADCF with SAC between Jan 2010 and Dec 2014 were evaluated prospectively. Fusion was assessed using standard X-rays with flexion/extension&nbsp; views. The clinical outcomes evaluated by Visual Analogue Scale for pain and Odom&rsquo;s criteria. <o:p></o:p></span></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height:&#10;normal;mso-layout-grid-align:none;text-autospace:none"><span lang="EN-IN" style="font-size:12.0pt;font-family:&quot;Candara&quot;,&quot;sans-serif&quot;;mso-bidi-font-family:&#10;Palatino-Roman">&nbsp;</span></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height:&#10;normal;mso-layout-grid-align:none;text-autospace:none"><b><span lang="EN-IN" style="font-size:12.0pt;font-family:&quot;Candara&quot;,&quot;sans-serif&quot;;&#10;mso-bidi-font-family:Palatino-Roman">Results:</span></b><span lang="EN-IN" style="font-size:12.0pt;font-family:&quot;Candara&quot;,&quot;sans-serif&quot;;mso-bidi-font-family:&#10;Palatino-Roman">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; The majority were Males&nbsp; (9 vs 6) with average age of 43.1 Mean followup period was 61.3 months. Out of the 15 cases &nbsp;in 7 cases we used Titanium cage and 8 cases we used PEEK cage. Fusion rate was 86.6%. In two cases we did a double level disc with good clinical outcome. Our patients had 5.4 scales improvement on VAS Score on average. One of our case got infected and cage exit was done and in one other case anterior pull out of the cage was seen without affecting the neurology of the patient so we did not plan for any second procedure in that patient. <o:p></o:p></span></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height:&#10;normal;mso-layout-grid-align:none;text-autospace:none"><span lang="EN-IN" style="font-size:12.0pt;font-family:&quot;Candara&quot;,&quot;sans-serif&quot;;mso-bidi-font-family:&#10;Palatino-Roman">&nbsp;</span></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height:&#10;normal;mso-layout-grid-align:none;text-autospace:none"><b><span lang="EN-IN" style="font-size:12.0pt;font-family:&quot;Candara&quot;,&quot;sans-serif&quot;;&#10;mso-bidi-font-family:Palatino-Roman">Conclusion:</span></b><span lang="EN-IN" style="font-size:12.0pt;font-family:&quot;Candara&quot;,&quot;sans-serif&quot;;mso-bidi-font-family:&#10;Palatino-Roman">&nbsp;&nbsp;&nbsp; Discectomy with Standalone cage is a safe and effective procedure providing favourable clinical and radiological outcome. &nbsp;Good fusion rates can be obtained (86.6% in our study) with this method.<o:p></o:p></span></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height:&#10;normal;mso-layout-grid-align:none;text-autospace:none"><b><span lang="EN-IN" style="font-size:12.0pt;font-family:&quot;Candara&quot;,&quot;sans-serif&quot;;mso-bidi-font-family:&#10;Palatino-Bold">&nbsp;</span></b></p>

Keywords :


Cite This Article:

Dr.K.Velmurugan, Dr.Hemanthakumar, Dr.M.Sathish, Outcome Analysis of Discectomy with Standalone Cage for Management of Cervical Disc Prolapse, GLOBAL JOURNAL FOR RESEARCH ANALYSIS : VOLUME-6, ISSUE-9, SEPTEMBER-2017


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