Open Access, Peer-reviewed
pISSN 1226-2102
eISSN 2005-8918
    J Korean Orthop Assoc. 2016 Jun;51(3):191-198. Korean.
    Published online Jun 22, 2016.
    https://doi.org/10.4055/jkoa.2016.51.3.191
    Copyright © 2016 by The Korean Orthopaedic Association
    Original Article

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

    Dae Moo Shim, M.D., Tae Kyun Kim, M.D., Sung Kyun Oh, M.D.,* Seung Whan Kuk, M.D., Bong Jun Jang, M.D. and Ji Woong Choi, M.D.
      • Department of Orthopaedic Surgery, Institute of Wonkwang Medical Science, Wonkwang University School of Medicine, Iksan, Korea.
      • *Department of Orthopaedic Surgery, Wonkwang University Sanbon Hospital, Gunpo, Korea.
    • Correspondence to: Sung Kyun Oh, M.D. Department of Orthopaedic Surgery, Wonkwang University Sanbon Hospital, 327 Sanbon-ro, Gunpo 15865, Korea. TEL: +82-31-390-2224, FAX: +82-31-398-2223, Email: niceo@daum.net
    Received May 20, 2015; Revised August 25, 2015; Accepted October 10, 2015.

    This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

    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.

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

    Figures

    Figure 1
    Intra-operation finding.

    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.

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

    Tables

    Table 1
    Clinical Outcomes

    Table 2
    Radiologic Outcome

    Table 3
    Implant Related Complications

    Notes

    CONFLICTS OF INTEREST:The authors have nothing to disclose.

    This work was supported by research grant of Wonkwang University in 2016.

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    MeSH Terms
    Follow-Up Studies*
    Humans
    Incidence
    Methods
    Neck
    Postoperative Complications
    Radiculopathy
    Retrospective Studies
    Spinal Cord Diseases
    Metrics
    Share
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    Tables
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