The use of anterior cervical interbody spacer with integrated fixation screws for the management of cervical disc disease / Ehab Adel Elbaz ; Supervised Yasser Elmiligui , Wael Koptan , Ahmed Maher Sultan

Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Orthopedic Surgery

Background: Multiple techniques and implants can be used in ACDF, the newest of which are integrated cage and screw constructs. These devices may be beneficial over anterior plate constructs due to a negligible anterior profile that may reduce dysphagia. Methods All patients had undergone ACDF from September 2013 till August 2015. All patients received a PEEK Prevail implant (medtronic spine). The neck disability Index (NDI) and visual analog scale (VAS) scores for arm and neck pain were documented. Dysphagia was determined using the bazaz criteria. Prevertebral soft-tissue thickness, spinal alignment, and subsidence were assessed as well. Results consecutive 25 patients with radiculopathy/myelopathy underwent an ACDF procedure using the "zero-profile" implant (30 levels operated). A CT scan at 12-months was taken to assess fusion status, implant failure, subsidence and migration. Fusion was noted in 92% of the operated levels in 6 months and 100% after one year follow up. 5 out of 25 patients (20%) complained about dysphagia related symptoms. dysphagia resolved in 5 weeks at 24 months follow-up. VAS improved from an average of 5.28+2.42 preoperatively to 2.48+1.71 immediately postoperatively and was maintained at 12 months. Patient reported improvements in axial neck pain and neurologic deficit. Reported improvements were sustained for 12 months. Conclusions The low profile integrated device improved lordosis and Fusion rates are consistent with ACDF using anterior plating. In combination with improvements in pain and a minimal rate of dysphagia, study findings support the use of integrated interbody spacers for use in ACDF procedures

Issued also as CD