Comparative Study of Functional Outcome of Anterior Cervical Decompression and Interbody Fusion With Tricortical Stand-Alone Iliac Crest Autograft Versus Stand-Alone Polyetheretherketone Cage in Cervical Spondylotic Myelopathy.

Abstract

STUDY DESIGN:

Retrospective analysis of prospectively collected data.

OBJECTIVE:

The aim of the study was to compare the outcome of anterior cervical decompression and fusion (ACDF) with stand-alone tricortical iliac crest autograft versus stand-alone polyetheretherketone (PEEK) cage in cases of cervical spondylotic myelopathy.

METHODS:

Prospectively collected data of 60 patients in each group were compared.

RESULTS:

There was statistically significant improvement noted in postoperative Modified Japanese Orthopaedic Association (MJOA) follow-up scores with comparison pairs of preoperative versus 6 months, preoperative versus 1 year, and 3 months versus 6 months, 3 months versus 1 year in both groups. But improvements in MJOA scores were statistically insignificant between 6 months and 1 year (P = .0639) for the autograft group when compared with PEEK cage group (P = 0001). The mean loss of segmental lordosis on follow-up X-ray for the autograft group was (5.89 ± 2.90°), which was significantly higher (1.88 ± 2.77°) than the mean loss seen in the PEEK cage group (P = .01). This was most evident between 6 months and 1 year, resulting in plateauing of the improvement in MJOA score between 6 months to 1 year in the autograft group. While there was no statistical difference between fusion rates between the groups for 1 and 2 levels of ACDF, overall fusion rates were significantly better for 1-level ACDF (95.74%) when compared with 2-level ACDF (76.00%).

CONCLUSION:

ACDF with PEEK cage is the fusion technique of choice for cervical fusion with fewer complications and better functional recovery in the treatment of cervical spondylotic myelopathy.

• Authors: Ayush Sharma, Hari Kishore, Vijay Singh, Ahmed Shawky Abdelgawaad, Shorabh Sinha, Prashant Chandrakant Kamble, Kailash Jorule, Romit Agrawal, Sumit Mathapati, Priyank Deepak
• Journal: Global spine journal (Global Spine J) Vol. 8 Issue 8 Pg. 860-865 (Dec 2018) ISSN: 2192-5682 [Print] England
• PMID: 30560039 (Publication Type: Journal Article)