Anterior Cervical Corporodesis in Degenerative Diseases of Cervical Spine: A Method Choice

I.V. Volkov*, I.Sh. Karabaev*, B.P. Fadeev*, V.E. Parfenov**, V.A. Manukovskiy**

* City Hospital N2, Saint Petersburg, Russia
** Medicomilitary Academy, Saint Petersburg, Russia

 

There were 122 cases, operated in 2003-2008. Anterior cervical decompression and corporodesis at one or several levels were performed. The cases were divided into 4 groups, depending on a method of corporodesis: an autobone (17 cases), an autobone with fixation by a plate (23), a cage with (38) or without a plate (44). The results were estimated on the basis of the NDI (questionnaire for revealing disorders of everyday activity in pain in the neck) and Scale of Japanese Orthopedic Association (JOA) before and a year after operation. Spondylographic examination, aimed at assessment of bone block formation, was carried out a year after intervention.

Results. Group 1 was characterized by reliable reduction of NDImean (from 23.7±2.4 up to 8.4±1.8; p<0.05), increase of JOAmean (from 7.7±0.9 up to 13.1±1.2; p<0.05); a bone block formation was present in 17 cases (100%). As for group 2, there were reduction of NDImean (from 21.6±2.1 up to 9.3±1.9; p<0.05), increase of JOAmean (from 8.2±1.1 up to 12.5±1.3; p<0.05); a full-value bone block was watched in 23 cases (100%). Indices in group 3 were as follows: reduction of NDImean (from 19.9±1.6 up to 10.4±2.2; p<0.05), increase of JOAmean (from 9.1±0.8 up to 13.1±1.0: p<0.05); a bone block was observed in 35 cases (92.1%). Group 4 had the following parameters: reduction of NDImean (from 23.4±1.5 up to 11.2±1.9; p<0.05), increase of JOAmean (from 8.3±1.2 up to 12.6±0.7; p<0.05); a number of cases with a bone block was 40 (90.9%). There were no reliable difference in clinical results in the above groups, as well as cases with implant migration. In contrast to autobone, use of a cage results in a primarily stable segment, allows to avoid reduction of its height in a bone block formation and does not demand a transplant. We consider it possible to use only cages, as clinical results of both single- and multi-level operations are similar to those, obtained with the help of other methods. Besides, cages permit to reduce operation duration and its cost.