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Chen X.-M.,Military Spinal Surgery Center | Ma H.-S.,Military Spinal Surgery Center | Tan R.,Military Spinal Surgery Center | Tian T.,Military Spinal Surgery Center | And 3 more authors.
Chinese Journal of Tissue Engineering Research

BACKGROUND: Ideal method for spinal fusion is interbody fusion, which was firstly applied by Robinson and Smith in 1955 on the removal of herniated intervertebral discs through the anterior cervical approach, followed by interbody grafting. Subsequently the presumption of interbody contents emerges to promote spinal fusion. The spinal interbody fusion has achieved significant developments and is considered one of standard treatments for spinal degeneration. OBJECTIVE: To investigate the long-term efficacy of multilevel anterior cervical decompression and cage-assisted fusion for cervical spondylosis. METHODS: From October 2000 to October 2002, twenty cases with cervical spondylosis underwent three-level cage-assisted anterior cervical depression and fusion in the 306 Hospital of Chinese PLA (including 15 males and 5 females). The involved patients aged 48-65 years, with mean 56.4 years. The affected lesions were observed at the C4-7level in 12 cases and at the C3-6 level in 8 cases. JOA scores were recorded before treatment and at final follow-up to evaluate the improvement rate. Clinical results were graded using the Odom criteria. Radiological results at the anterioposterior and lateral film positions were observed before and after treatment, as well as at final follow-up. Cervical spine curvature (Cobb angle) was measured before and after treatment. Adjacent segment degeneration and graft fusion rate were observed upon final follow-up. RESULTS AND CONCLUSION: All 20 patients were successfully operated. No neurological and fixation-related complications occurred. The follow-up period was arranged from 10 to 132 months. The JOA score was (9.85 ± 0.81) preoperatively and (14.40 ± 0.94) postoperatively, showing significant difference. The average JOA improvement rate was 81%. Odom grading at final follow-ups included 14 excellent cases, 4 good cases, and 2 fair cases. No adjacent segment lesions were observed, Cage sedimentation was visible in two cases, and cervical curve maintained good. Graft fusion rate was 100% at final follow-up. Radiograph analysis indicated that, Cobb angle of cervical lordosis was significantly higher at postoperative 1 year and at final follow-up compared with preoperative measurement (P < 0.01), and no difference was significant between postoperative 1 year and final follow-up (P > 0.05). Multilevel cage-assisted anterior cervical decompression and fusion is an effective and safe way for multilevel cervical spondylosis and the long-term outcomes are good. © 2014, Journal of Clinical Rehabilitative Tissue Engineering Research. All rights reserved. Source

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