| Anterior Cervical Interbody Fusion with Titanium Cage(AMSLUTM): Pitfalls and Complications |
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Jae Hoon Kim, M.D., Koang Hum Bak, M.D., Jin Hwan Cheong, M.D., Choong Hyun Kim, M.D., Jae Min Kim, M.D., Seong Hoon Oh, M.D. |
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Department of Neurosurgery, Eulji University Medical Center, Seoul, Korea |
| Cylindrical Cage(AMSLUTM Cage)를 이용한 경추 전방 융합술의 단기 수술 결과 분석 |
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김재훈1ㆍ백광흠ㆍ정진환ㆍ김창현ㆍ김재민ㆍ오성훈 |
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을지대학교 의과대학 신경외과학교실, 한양학교 의과대학 신경외과학교실 |
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| Abstract |
Objective: The use of artificial cage in anterior cervical discectomy with fusion has increased widely. Recently standalone cages(AMSLUTM) of various materials have been developed, which provide immediate biomechanical stability and elimi nate donor site morbidity. However, the complications(subsidence of intervertebral space and pseudoarthrosis) of the pre- vious use of titanium cage have not been previously well reported.
Methods: The authors investigated the clinical and radiological features of 10 cases who underwent reoperation after anterior cervical fusion by using titanium cages compared with uncomplicated cases during the period between January 2001 and December 2004 at Hanyang university Guri hospital.
Results: All patients complained of severe nuchal pain and vague discomfort around their neck. Three patients com- plained of paraparesis. In 4 cases, it happened that the recompression on the nerve root by the subsidence of inter- vertebral space. And the pseudoarthrosis was observed on flexion-extension cervical X-ray film in 6 cases. All patients underwent removal of cage and interbody fusion with allograft or surgical MESH and anterior plating system except one who underwent foraminotomy without removal of cage. Symptomatic improvement was found in 9 cases. Surgeryrelated com- plication was not seen. There was a significant correlation between preoperative duration of symptom and reoperation(p=0.017). Also younger patients and non-union were statistically significant factors causing reoperation(p=0.039, p= 0.045 respectively).
Conclusion: Anterior fusion with metal cage could cause excessive subsidence and pseudoarthrosis. Careful preope- rative and intraoperative considerations should be given to prevent these complications. Extended studies about metal cages are necessary to improve clinical outcomes and avoid shortcomings of fusion technology with metal cages. |
| Keywords:
Anteiror cervical interbody fusionㆍCageㆍPseudoarthrosisㆍSubsidence |
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