![]() Neutral anteroposterior, lateral, and dynamic flexion-extension lateral radiographs were obtained at each study point. ![]() Routine radiographs were used to assess spinal alignment, arthrodesis, bone ingrowth, subsidence, and any visible shift or position changes of the implant. Overall neurological status success was determined by maintenance or improvement in all three clinical findings. Success for each of these three objective findings was based on postoperative maintenance or improvement in condition compared with preoperative status. Neurological status was determined by measuring three objective clinical findings: motor function, sensory function, and deep tendon reflexes. Standardized outcome measures including Neck Disability Index (NDI) ( 18, 19) and axial cervical pain and radicular arm pain visual analog numerical scores (VAS) were used to benchmark preoperative and postoperative condition in this context. ![]() Operative procedure details and adverse events were recorded. Safety and effectiveness were evaluated in the course of the above. We present the following study in accordance with the STROBE reporting checklist (available at ).ĭata was acquired and compiled preoperatively, intraoperatively, and at standard postoperative intervals of 3, 6, 12, and 24 months. The purpose of this retrospective case series study was to evaluate the safety and effectiveness of a third-generation bioactive glass synthetic bone graft replacement ( 11, 16, 17) as a method of facilitating spinal fusion at multiple levels in patients with symptomatic cervical degenerative disc disease. Porous PEEK implants used with autograft have been shown to have a high rate of fusion and improved clinical outcomes ( 14, 15). The type of graft and interbody spacer impacts clinical and radiographic outcomes ( 12, 13). The successful progression to fusion and healing is influenced by multiple factors. Spinal fusion requires a complex cascade of biologic events and osseous union is not always successful. Bioactive glasses have converged into the third-generation with the ability to activate genes and stimulate bone formation ( 11). The materials produced demonstrated biological inertness with body fluids (first-generation), the production of a strong tissue-implant bond (second-generation) and genetic activation of specific cell pathway (third-generation) ( 11). One such alternative, bioactive glass, has shown the ability to produce an environment conducive for bone formation and has been utilized in various specialties, including ENT and Dentistry, over the last twenty years as a synthetic bone graft substitute ( 10).īiomaterials have evolved over the last fifty years, from generation to generation through bioengineering. ![]() Due to the donor site morbidity of iliac crest harvest, bone substitute alternatives have become increasingly attractive. It is well supported that autogenous grafts demonstrate improved rates of fusion when compared to allografts ( 6- 8) however, separate incision bone graft harvesting techniques are associated with donor site pain ( 9). One of the grafting materials used for promoting fusion is autogenous iliac crest bone graft (ICBG). There are various grafting techniques that have been described to accomplish these goals ( 3- 5). ACDF is well established as reliably effective in achieving improved patient outcomes and satisfaction for singe level and multi-level cervical spondylosis ( 1, 2).įollowing anterior decompression the aims of cervical interbody fusion are to provide stabilization, maintain segmental lordosis, and restored anatomic disc space height. Indirect decompression of the canal and neuroforamina can also be achieved simultaneously during restoration of disc space height as well as normal segmental lordosis. Anterior discectomy and interbody fusion (ACDF) is routinely engaged to decompress the central spinal canal and neuroforamina by direct removal of disc fragments, radial osteophytes, and uncovertebral joint osteophytes.
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