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Anterior Cervical Interbody Fusion with Solis? A Cage and Allograft for Cervical Disc Diseases: Poster #21

Kim, Se‐Hoon MD; Park, Juno MD; Kim, Sang‐Dae MD; Lim, Dong‐Jun MD; Park, Jung‐Yul MD; Chung, Hung‐Seob MD1

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Spine Journal Meeting Abstracts: 2005 - Volume - Issue 7 - p 198–199
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INTRODUCTION: The preliminary report using the radiolucent poly‐ether‐ether‐ketone (PEEK) cage (Solis; Stryker® Instruments) and autogenous iliac crest graft for anterior cervical interbody fusion revealed that the cage showed relatively high fusion rate and few complications associated with hardware. The authors try to evaluate the efficacy of allograft and Solis cage for various cervical disc diseases.

METHODS: From April 2003 to December 2004, twenty seven patients with degenerative cervical disease underwent anterior cervical microdiscectomy and interbody fusion with the Solis cage. For adequate bone fusion, human allograft (TranZgraft®, TBI/National Processing Center, CA) was used in all patients. Pain relief and clinical outcome were evaluated according to Odom's criteria and radiological assessment was performed in terms of intervertebral disc height, cervical lordosis, and fusion status on the basis of dynamic X‐rays and CT. The mean follow‐up period was 12 months.

RESULTS: Single level fusion was accomplished in 25 patients and two levels in 2 patients. The clinical outcome was excellent or good in 25 cases (92.6%) and fair in 2 (7.4%) during the follow‐up period. The mean of disc height and cervical lordosis were significantly improved after surgery and well preserved in most patients. Significant cage subsidence was noted in 2 patients (7.4%) without worsening of symptom (Fig. 1). Bony fusion was confirmed in all patients by cervical dynamic X‐rays and CT (Fig. 2), and no cage displacement, rotation, or retropulsion was identified in the follow‐up. A transient hypoglossal nerve paralysis was noted in a patient with cervical spondylotic myelopathy of C3/4, but there was no case of worsening of symptom.

Figure 1
Figure 1:
Figure 1. Postoperative cervical radiograph after 6 months revealed a profound cage subsidence at C6/7 despite the patient complained of no worsening of symptom.
Figure 2
Figure 2:
Figure 2. Postoperative axial and reconstructed sagittal CT images after 6 months demonstrate a good fusion status at C5/6.

CONCLUSIONS: Even though there were 2 cases of asymptomatic cage subsidence, anterior cervical fusion with the Solis cage and allograft showed relatively high fusion rate and good maintenance of the intervertebral disc height and cervical lordosis. The procedure also has several advantages such as easy maneuverability, avoidance of graft donor site complications, and few complications associated with hardware throughout the follow‐up period.

If noted, the author indicates something of value received. The codes are identified as: a‐ research or institutional support; b‐ miscellaneous funding; c‐ royalties; d‐ stock options; e‐ consultant or employee; n‐ no conflicts disclosed, and * disclosure not available at the time of printing. For full information, refer to inside of back cover.

© 2005 Lippincott Williams & Wilkins, Inc.