The Experts below are selected from a list of 2886 Experts worldwide ranked by ideXlab platform
Rick B. Delamarter - One of the best experts on this subject based on the ideXlab platform.
-
increased fusion rates with Cervical plating for three level anterior Cervical Discectomy and fusion
Spine, 2000Co-Authors: Jeffrey C. Wang, Paul W Mcdonough, Kevin K Endow, Linda E A Kanim, Rick B. DelamarterAbstract:Study Design. A retrospective review of all patients surgically treated by a single surgeon with a three-level anterior Cervical Discectomy and fusion with and without anterior plate fixation. Objectives. To compare the clinical and radiographic success of anterior three-level Discectomy and fusion performed with and without anterior Cervical plate fixation. Summary of Background Data. Previous studies of multilevel Cervical discectomies and fusions have shown fusion rates to decrease as the number of surgical levels increases. Anterior Cervical plate stabilization can provide more stability and may increase fusion rates for multilevel fusions. Methods. Over a 7-year period, 59 patients were treated surgically with a three-level anterior Cervical Discectomy and fusion by the senior author. Forty patients had Cervical plates, whereas 19 had fusions with no plates. These patients were observed for an average of 3.2 years. Clinical and radiographic follow-up data were obtained. Results. Of the 59 patients, 14 had a pseudarthrosis (7 in each group). The pseudarthrosis rates were 18% (7 of 40) for patients with plating and 37% (7 of 19) for patients with no plating. Although the nonunion rate for unplated fusions was double that of plated fusions, this difference was not statistically significant. There was no statistically significant correlation between pseudarthrosis and gender, age, level of surgery, history of tobacco use, or previous anterior surgery. The fusion rates were improved with the use of a Cervical plate. Inferior clinical results were demonstrated in patients with a pseudarthrosis, regardless of the use of a Cervical plate. Conclusions. The addition of plate fixation for three-level anterior Cervical Discectomy and fusion is a safe procedure and does not result in higher complication rates. In this study, the pseudarthrosis rate was lower for patients with a Cervical plate. However, this difference was not statistically significant. Patients treated with Cervical plating had overall better results when compared with those of patients treated without Cervical plates. Although the use of Cervical plates decreased the pseudarthrosis rate, a three-level procedure is still associated with a high nonunion rate, and other strategies to increase fusion rates should be explored.
-
increased fusion rates with Cervical plating for three level anterior Cervical Discectomy and fusion
Spine, 2000Co-Authors: Jeffrey C. Wang, Paul W Mcdonough, Kevin K Endow, Linda E A Kanim, Rick B. DelamarterAbstract:Study design A retrospective review of all patients surgically treated with a two-level anterior Cervical Discectomy and fusion with and without anterior plate fixation by a single surgeon. Objectives To compare the clinical and radiographic success of two-level Discectomy and the effect of anterior Cervical plate fixation. Summary of background data Prior studies of multisegment fusions have shown decreased fusion rates correlating with the number of increased levels. The use of anterior plates for single-level Cervical fusions is controversial. However, their use in multilevel fusions may be warranted because of the increased pseudarthrosis rates. Methods Over a 6-year period, 60 patients were treated surgically with a two-level anterior Cervical Discectomy and fusion by the senior author. Thirty-two patients had Cervical plates, and 28 underwent fusions without plates. These patients were followed for an average of 2.7 years. Clinical and radiographic follow-up evaluations were performed. Results Of the 60 patients, 7 had a pseudarthrosis. The pseudarthrosis rates were 0% for patients with plating and 25% for those with no plating. This difference was statistically significant (P = 0.003). No correlation of pseudarthrosis with gender, age, level of surgery, history of tobacco use, or the presence of prior anterior surgery was found. There was significantly less graft collapse (P = 0.0001) in the patients without plates in whom pseudarthrosis developed (1.4 mm) than in those who had fusions with plates (0.3 mm). The amount of kyphotic deformity of the fused segment was 0.4 degree in patients with plating compared with 4.9 degrees in those without plating who developed a pseudarthrosis (P = 0.0001). Conclusions The addition of plate fixation for two-level anterior Cervical Discectomy and fusion is a safe procedure with no significant increase in complication rates. The pseudarthrosis rates are significantly higher in patients treated without plate fixation. No nonunions occurred in the patients treated with plate fixation. There was significantly less disc space collapse and kyphotic deformity with the plated fusions than with the nonplated fusions, in which a pseudarthrosis developed. The complication rates for plated fusions are extremely low and do not differ from those for nonplated fusions.
-
the effect of Cervical plating on single level anterior Cervical Discectomy and fusion
Journal of Spinal Disorders, 1999Co-Authors: Jeffrey C. Wang, Paul W Mcdonough, Kevin K Endow, Linda E A Kanim, Rick B. DelamarterAbstract:The use of anterior plates for single-level Cervical fusions is controversial. Previous studies that evaluated single and multiple-level fusions have shown increased and decreased fusion rates when Cervical plates are used. The purpose of this study was to compare the clinical and radiographic success of single-level Discectomy performed with and without anterior Cervical plate fixation. During a 6-year period, 80 patients were surgically treated with a single-level anterior Cervical Discectomy. Forty-four patients had Cervical plates, whereas 36 had fusions without plates (average follow-up, 2.3 years). The pseudarthrosis rates were 4.5% (2 of 44) for patients with plating and 8.3% (3 of 36) without plating. This difference was not significant (p = 0.653). There was no correlation of pseudarthrosis with sex, age, level of surgery, history of tobacco use, or the presence of previous anterior surgery. The amount of graft collapse for patients with plating was 0.75 mm compared with 1.5 mm for those without a plate (p = 0.026). The amount of kyphotic deformity of the fused segment was 1.2 degrees with plating compared with 1.9 degrees for patients without plating (p = 0.079). Ninety-one percent of the patients with plating had good or excellent results compared with 88% in the group without Cervical plates, based on Odom's criteria. The addition of plate fixation for single-level anterior Cervical Discectomy and fusion is safe and not associated with a significant increase in complication rates. The pseudarthrosis rates are not significantly different when a Cervical plate is used.
Sheeraz A Qureshi - One of the best experts on this subject based on the ideXlab platform.
-
predictive factors of postoperative dysphagia in single level anterior Cervical Discectomy and fusion
Spine, 2019Co-Authors: Avani S Vaishnav, Sheeraz A Qureshi, Philip Saville, Steven J Mcanany, Dil V Patel, Brittany E Haws, Benjamin Khechen, Kern Singh, Catherine Himo GangAbstract:Study Design.Retrospective review of prospectively collected data.Objective.To investigate if zero profile devices offer an advantage over traditional plate/cage constructs for dysphagia rates in single level anterior Cervical Discectomy and fusion (ACDF).Summary of Background Data.Dysphagia rates f
-
the 5 year cost effectiveness of anterior Cervical Discectomy and fusion and Cervical disc replacement a markov analysis
Spine, 2014Co-Authors: Steven J Mcanany, Andrew C Hecht, Samuel C Overley, Evan O Baird, Samuel K Cho, Jack E Zigler, Sheeraz A QureshiAbstract:Study Design.A Markov state-transition model was developed to evaluate the cost-effectiveness of anterior Cervical Discectomy and fusion (ACDF) and Cervical disc replacement (CDR) at 5 years.Objective.To determine the cost-effectiveness of ACDF and CDR at 5 years.Summary of Background Data.ACDF and
-
arytenoid dislocation as a cause of prolonged hoarseness after Cervical Discectomy and fusion
Global Spine Journal, 2013Co-Authors: Vadim Goz, Sheeraz A Qureshi, Andrew C HechtAbstract:Study Design Case series of two arytenoid dislocations after anterior Cervical Discectomy. Objective To recognize arytenoid dislocation as a possible cause of prolonged hoarseness in patients after anterior Cervical discectomies. Summary of Background Data Prolonged hoarseness is a common postoperative complication after anterior Cervical spine surgery. The etiology of prolonged postoperative hoarseness is usually related to a paresis of the recurrent laryngeal nerve. However, other causes of postoperative hoarseness may be overlooked in this clinical scenario. Other possible etiologies include pharyngeal and laryngeal trauma, hematoma and edema, injury of the superior laryngeal nerve, as well as arytenoid cartilage dislocation. Arytenoid dislocation is often misdiagnosed as vocal fold paresis due to recurrent or laryngeal nerve injury. Methods We report two cases of arytenoid dislocation and review the literature on this pathology. Results Two patients treated with anterior Cervical Discectomy and fusion experienced prolonged postoperative hoarseness. Arytenoid dislocation was confirmed by flexible fiber-optic laryngoscopy in both cases. The dislocations experienced spontaneous reduction at 6 weeks and 3 months postsurgery. Conclusions Arytenoid dislocation must be considered in the differential diagnosis of prolonged postoperative hoarseness and evaluated for using direct laryngoscopy, computed tomography, or a laryngeal electromyography. Upon diagnosis, treatment must be considered immediately. Slight dislocations can reduce spontaneously without surgical intervention; however, operative intervention may be required at times.
Ronald H. M. A. Bartels - One of the best experts on this subject based on the ideXlab platform.
-
Symptomatic Adjacent Segment Disease After Anterior Cervical Discectomy for Single-level Degenerative Disk Disease.
Journal of Spinal Disorders & Techniques, 2018Co-Authors: Roland Donk, Wim I.m. Verhagen, Allard J. F. Hosman, André L. M. Verbeek, Ronald H. M. A. BartelsAbstract:STUDY DESIGN: A prospective cohort of 142 patients underwent either anterior Cervical Discectomy alone, anterior Cervical Discectomy with fusion by cage stand-alone, or anterior Cervical Discectomy with arthroplasty. We then followed up on their condition for a mean of 9.1+/-1.9 years (5.6-12.2 y) later. OBJECTIVE: We aimed to evaluate the annual rate of clinically symptomatic adjacent segment disease (ASD) and to analyze predictive factors. SUMMARY OF BACKGROUND DATA: Until recent, ASD has been predominantly evaluated radiologically. It is not known whether all patients had complaints. A frequent cited annual rate of ASD is 2.9%, but a growing number of studies report a lower annual rate. Furthermore, maintaining motion to prevent ASD is one reason for implanting a Cervical disk prosthesis. However, the results of studies contradict one another. METHODS: Participants took part in a randomized controlled trial that ended prematurely because of the publication of evidence that did not justify continuation of the trial. The patients were randomly allocated to 3 groups, each of which received one of the abovementioned treatments. We defined symptomatic ASD as signs and symptoms caused by degeneration of an intervertebral disk adjacent to a level of previous anterior Cervical disk surgery. At the last follow-up, we were able to ascertain whether clinically symptomatic ASD was present in any of the participants. RESULTS: The overall annual rate of symptomatic ASD was 0.7%. We found no statistically significant correlations between any of the investigated factors and symptomatic ASD except for the surgical method used. Symptomatic ASD was seen less often in anterior Cervical Discectomy solely or anterior Cervical Discectomy with arthroplasty than in anterior Cervical Discectomy with fusion by plate fixation. CONCLUSIONS: The annual rate of symptomatic ASD after an anterior Cervical Discectomy procedure was estimated to be 0.7%. This seems to be related to the procedure, although firm conclusions cannot be drawn. LEVEL OF EVIDENCE: Level 2-prospective cohort.
Pradhan Abhinav - One of the best experts on this subject based on the ideXlab platform.
-
an updated meta analysis comparing artificial Cervical disc arthroplasty cda versus anterior Cervical Discectomy and fusion acdf for the treatment of Cervical degenerative disc disease cddd
Spine, 2015Co-Authors: Fuqiang Gao, Tianli Mao, Wei Sun, Wanshou Guo, Yunting Wang, Pradhan AbhinavAbstract:Study Design.A meta-analysis of published randomized controlled Trials (RCTs).Objective.The aim of this study was to compare the efficacy and safety of Cervical disc arthroplasty (CDA) with anterior Cervical Discectomy and fusion (ACDF) for the treatment of one-level Cervical degenerative disc disea
Jeffrey C. Wang - One of the best experts on this subject based on the ideXlab platform.
-
structural allograft versus peek implants in anterior Cervical Discectomy and fusion a systematic review
Global Spine Journal, 2019Co-Authors: Jeffrey C. Wang, Amit Jain, Majd Marrache, Andrew P Harris, Varun Puvanesarajah, Brian J Neuman, Zorica Buser, Tim S YoonAbstract:Study Design:Systematic literature review.Objective:Our primary objective was to compare reported fusion rates after anterior Cervical Discectomy and fusion (ACDF) using structural allograft versus...
-
increased fusion rates with Cervical plating for three level anterior Cervical Discectomy and fusion
Spine, 2000Co-Authors: Jeffrey C. Wang, Paul W Mcdonough, Kevin K Endow, Linda E A Kanim, Rick B. DelamarterAbstract:Study Design. A retrospective review of all patients surgically treated by a single surgeon with a three-level anterior Cervical Discectomy and fusion with and without anterior plate fixation. Objectives. To compare the clinical and radiographic success of anterior three-level Discectomy and fusion performed with and without anterior Cervical plate fixation. Summary of Background Data. Previous studies of multilevel Cervical discectomies and fusions have shown fusion rates to decrease as the number of surgical levels increases. Anterior Cervical plate stabilization can provide more stability and may increase fusion rates for multilevel fusions. Methods. Over a 7-year period, 59 patients were treated surgically with a three-level anterior Cervical Discectomy and fusion by the senior author. Forty patients had Cervical plates, whereas 19 had fusions with no plates. These patients were observed for an average of 3.2 years. Clinical and radiographic follow-up data were obtained. Results. Of the 59 patients, 14 had a pseudarthrosis (7 in each group). The pseudarthrosis rates were 18% (7 of 40) for patients with plating and 37% (7 of 19) for patients with no plating. Although the nonunion rate for unplated fusions was double that of plated fusions, this difference was not statistically significant. There was no statistically significant correlation between pseudarthrosis and gender, age, level of surgery, history of tobacco use, or previous anterior surgery. The fusion rates were improved with the use of a Cervical plate. Inferior clinical results were demonstrated in patients with a pseudarthrosis, regardless of the use of a Cervical plate. Conclusions. The addition of plate fixation for three-level anterior Cervical Discectomy and fusion is a safe procedure and does not result in higher complication rates. In this study, the pseudarthrosis rate was lower for patients with a Cervical plate. However, this difference was not statistically significant. Patients treated with Cervical plating had overall better results when compared with those of patients treated without Cervical plates. Although the use of Cervical plates decreased the pseudarthrosis rate, a three-level procedure is still associated with a high nonunion rate, and other strategies to increase fusion rates should be explored.
-
increased fusion rates with Cervical plating for three level anterior Cervical Discectomy and fusion
Spine, 2000Co-Authors: Jeffrey C. Wang, Paul W Mcdonough, Kevin K Endow, Linda E A Kanim, Rick B. DelamarterAbstract:Study design A retrospective review of all patients surgically treated with a two-level anterior Cervical Discectomy and fusion with and without anterior plate fixation by a single surgeon. Objectives To compare the clinical and radiographic success of two-level Discectomy and the effect of anterior Cervical plate fixation. Summary of background data Prior studies of multisegment fusions have shown decreased fusion rates correlating with the number of increased levels. The use of anterior plates for single-level Cervical fusions is controversial. However, their use in multilevel fusions may be warranted because of the increased pseudarthrosis rates. Methods Over a 6-year period, 60 patients were treated surgically with a two-level anterior Cervical Discectomy and fusion by the senior author. Thirty-two patients had Cervical plates, and 28 underwent fusions without plates. These patients were followed for an average of 2.7 years. Clinical and radiographic follow-up evaluations were performed. Results Of the 60 patients, 7 had a pseudarthrosis. The pseudarthrosis rates were 0% for patients with plating and 25% for those with no plating. This difference was statistically significant (P = 0.003). No correlation of pseudarthrosis with gender, age, level of surgery, history of tobacco use, or the presence of prior anterior surgery was found. There was significantly less graft collapse (P = 0.0001) in the patients without plates in whom pseudarthrosis developed (1.4 mm) than in those who had fusions with plates (0.3 mm). The amount of kyphotic deformity of the fused segment was 0.4 degree in patients with plating compared with 4.9 degrees in those without plating who developed a pseudarthrosis (P = 0.0001). Conclusions The addition of plate fixation for two-level anterior Cervical Discectomy and fusion is a safe procedure with no significant increase in complication rates. The pseudarthrosis rates are significantly higher in patients treated without plate fixation. No nonunions occurred in the patients treated with plate fixation. There was significantly less disc space collapse and kyphotic deformity with the plated fusions than with the nonplated fusions, in which a pseudarthrosis developed. The complication rates for plated fusions are extremely low and do not differ from those for nonplated fusions.
-
the effect of Cervical plating on single level anterior Cervical Discectomy and fusion
Journal of Spinal Disorders, 1999Co-Authors: Jeffrey C. Wang, Paul W Mcdonough, Kevin K Endow, Linda E A Kanim, Rick B. DelamarterAbstract:The use of anterior plates for single-level Cervical fusions is controversial. Previous studies that evaluated single and multiple-level fusions have shown increased and decreased fusion rates when Cervical plates are used. The purpose of this study was to compare the clinical and radiographic success of single-level Discectomy performed with and without anterior Cervical plate fixation. During a 6-year period, 80 patients were surgically treated with a single-level anterior Cervical Discectomy. Forty-four patients had Cervical plates, whereas 36 had fusions without plates (average follow-up, 2.3 years). The pseudarthrosis rates were 4.5% (2 of 44) for patients with plating and 8.3% (3 of 36) without plating. This difference was not significant (p = 0.653). There was no correlation of pseudarthrosis with sex, age, level of surgery, history of tobacco use, or the presence of previous anterior surgery. The amount of graft collapse for patients with plating was 0.75 mm compared with 1.5 mm for those without a plate (p = 0.026). The amount of kyphotic deformity of the fused segment was 1.2 degrees with plating compared with 1.9 degrees for patients without plating (p = 0.079). Ninety-one percent of the patients with plating had good or excellent results compared with 88% in the group without Cervical plates, based on Odom's criteria. The addition of plate fixation for single-level anterior Cervical Discectomy and fusion is safe and not associated with a significant increase in complication rates. The pseudarthrosis rates are not significantly different when a Cervical plate is used.