Search

Anterior cervical discectomy and fusion is one of the most widely used surgical treatments for patients with degenerative cervical spine disease. It has been performed with various techniques and devices for many years. This is a retrospective study included 20 patients suffering from degenerative cervical disc disease. All these patients had an anterior approach for cervical discectomy in which the interbody fusion of 1 to 3 motion segments from C3 to C7 was done. The clinical and radiological data obtained were analyzed. All patients were regularly assessed through the follow up period of two years post surgical intervention. This study included 20 patients (14 males and 6 females). Patients' age ranged from 26 to 82 years with a mean of 45 years. Seventeen patients had a single level discectomy, two patients had two levels discectomy and one patient had 3 levels discectomy. The C5-6 being the most commonly affected level seen in 12 (60 %) patients. The mean operative time was 120±15 minutes. The changes in the visual analogue score, Japanese orthopedic association score and Nurick score were statistically significant in post operative. All patients had an evidence of fusion by the ninth month post operatively. Interbody fusion cages appear safe and effective, and their use helps to avoid some of the inherent problems in performing current anterior cervical fusion techniques. However, this outcome needs to be validated through more controlled trials with longer follow up. [ABSTRACT FROM AUTHOR]

Surgery of the degenerative cervical spine disease could be punctuated by certain complications (infectious, mechanical, neurological and esotracheal or CSF fistulas). We report a case of rejection of an interbody cage by the oral route during a coughing effort in a patient operated for cervical herniated disc. A 58-year-old man with no significant medical history. Clinically, he presented a cervical spinal cord compression syndrome (Nurick grade 4). Neuroimaging (CT and cervical MRI) found cervical arthrosis with myelopathy on herniated disc up to C3C4. An anterior approach was performed with C3-C4 discectomy and placement of an interbody cage. The immediate post-operative follow-up was simple with good recovery on the motor level apart from a difficulty in swallowing. After a year of evolution, the patient reported the expulsion of a foreign body (the interbody cage) during a coughing effort. An X-ray of the cervical spine confirms the absence of the cage. The esophageal fistulography returned without abnormalities. The classic complications in cervical spine fusion surgery with an interbody cage are the anterior secondary displacements with risk of esotracheal involvement or posterior with risk of radiculo-medullary involvement. These movements could be linked to a technical problem (malposition of the cage, unsuitable dimensions) causing the absence of body fusion. The rejection could also be linked to an intolerance of the patient's immune system to the foreign interbody cage. Rejection of the interbody cage by the oral route is an extremely rare and unusual complication. Its occurrence has not been previously reported as a complication of cervical spine surgery. It seems to us that this is the first case described in the literature. [ABSTRACT FROM AUTHOR]