Comparing anterior cervical fusion using titanium cage with hydroxyapatite and with autograft
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Date
2010-07-20
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Journal Title
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Publisher
Asian Biomedicine (Research Reviews and News)
Abstract
Background: Anterior cervical discectomy and fusion using autogenous iliac bone graft may lead to donor site
pain. This has led some surgeons to use hydroxyapatite but it has greater rates of complications.
Objective: Analyze results of the treatment of cervical spine spondylosis by anterior cervical discectomy, and
to compare fusion using titanium cage with hydroxyapatite and with autograft.
Methods: We evaluated eighty patients (at 146 cervical levels) that had been treated by anterior cervical
discectomy and fusion with hydroxyapatite or autograft. In a prospective study, patients were divided into two
groups: 1) 77 levels of anterior cervical fusion from in 40 patients who were treated with cage and hydroxyapatite,
and 2) 69 levels of anterior cervical fusions in 40 patients who were treated with cage and autograft. Results
were evaluated using the Japanese Orthopedic Association (JOA) scoring system before and after surgery,
subsidence, non-union and complication.
Results: According to JOA score, the first group (hydroxyapatite) had improved from 9.8 preoperation to 14.5
postoperation. The subsidence rate was 26.0%, the non-union rate was 10.4%, and there was no intra and
post-operative complication. In the other group (autograft), the preoperative JOA score had improved from 9.3 to
14.1. The subsidence rate was 11.6%, and there were no non-union and complications. Statistical significance
was found in non-union and subsidence aspect between groups, but the clinical outcome of JOA score was not
significantly different.
Conclusion: Anterior cervical discectomy and fusion in cervical spondylosis patients, titanium cage implantation
with hydroxyapatite is a highly useful alternative to autograft.
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Keywords
Anterior cervical fusion, autograft, hydroxyapatite
Citation
Asian Biomedicine (Research Reviews and News); Vol. 4 No. 1 February 2010; 147-152