Anterior cervical interbody fusion using carbon fiber cages

ABSTRACT

Anterior decompression and inter body fusion is a widely accepted surgical treatment for patients with cervical disc herniations and cervical spondylosis. Tricorticaf iliac crest autograft has been considered the classic method but problems such as graft collapse, and extrusion still persist. Cages were introduced because of their theoretical ability to prevent graft collapse. Carbon fiber cages for anterior cervical fusion will be evaluated in this study. Thirty two patients with symptomatic cervical disc disease were treated by anterior cervical discectomy and fusion using carbon fiber cages packed with autogenous bone graft. The average duration of symptoms was 9.3 months [range, 2-15 months]. The average follow-up was 28 months [range, 12-36 months]. All patients had neck pain. Twenty one patients [65.6%] had a single level affection, and eleven patients [34.4%] had double level affection with a total of 43 disc lesions. Fifteen patients [46.9%] had radiculopathy without myelopathy, ten patients [31.2%] had myelopathy without radiculopathy and seven patients [21.9%] had myeloradiculopathy. Four patients [12.5%] had sphinctric disturbances. Twenty seven patients [84.4%] had complete relief of neck pain. All patients improved neurologically postoperatively, except 2 patients [6.2%] with myelopathy although their symptoms stopped to progress. Maintenance of cervical lordosis or correction of kyphosis occurred in 29 patients [90.6%]. Fusion occurred in 40 disc lesions [93%]. Subsidence [< 5mm] occurred in 6 disc spaces [14%]. There were no implantrelated complications. Carbon fiber cages represent a good option to restore the intervertebral disc space and promote fusion in cervical disc surgery. Furthermore, the bone fusion can be easily assessed because of radiolucency of these cages