Comparison of the effectiveness and safety of bioactive glass ceramic to allograft bone for anterior cervical discectomy
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ORIGINAL ARTICLE
Comparison of the effectiveness and safety of bioactive glass ceramic to allograft bone for anterior cervical discectomy and fusion with anterior plate fixation Hyung Cheol Kim 1 & Jae Keun Oh 2 & Du Su Kim 1 & Jeffrey S. Roh 3 & Tae Woo Kim 1 & Seong Bae An 1 & Hyeong Seok Jeon 1 & Dong Ah Shin 1 & Seong Yi 1 & Keung Nyun Kim 1 & Do Heum Yoon 1 & Yoon Ha 1 Received: 31 August 2019 / Revised: 26 November 2019 / Accepted: 11 December 2019 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Recently, a bioactive glass ceramic (BGC) has been developed for use as intervertebral cages for anterior cervical discectomy and fusion (ACDF). However, the effectiveness and safety of BGC cages remain to be evaluated. We completed a retrospective comparison of the radiological and clinical outcomes of 36 patients (52 levels) who underwent ACDF with a BGC cage and 35 patients (54 levels) using allograft bone. The following variables were compared between the two groups: the visual analog (VAS) neck and arm pain score and the neck disability index (NDI), measured before surgery and 1 year after; the change in Cobb’s angle, between the C2 and C7 vertebrae, the global sagittal angle, and disc height compared from before surgery to 1 year after; and the rate of spinal fusion and cage subsidence at 1 and 2 years after surgery. The VAS and NDI scores were not different between the two groups. Similarly, the spinal fusion rate was not different between the BGC and allograft bone group at 1 year (73% and 87%, respectively; p = 0.07) and 2 years (94% and 91%, respectively; p = 0.54) after surgery. However, the rate of cage subsidence was higher in the allograft bone (43%) than the BGC (19%) group (p = 0.03), as was the rate of instrument-related failure (p = 0.028), with a specifically higher incidence of implant fracture or failure in the allograft bone group (p = 0.025). Overall, our findings indicate that BGC cages provide a feasible and safe alternative to allograft bone for ACDF. Keywords Anterior cervical discectomy and fusion . Bioactive glass ceramic cage . Allograft bone . Fusion rate . Clinical and radiological outcomes
Introduction Since it was first described by Smith and Robinson in 1958 [12, 27, 48], anterior cervical decompression and fusion (ACDF) has been one of the most common procedures performed to treat degenerative disease of the cervical spine [12, 27, 48]. With advances in the ACDF technique [7, 16], new Hyung Cheol Kim and Jae Keun Oh contributed equally to this work. * Yoon Ha [email protected] 1
Department of Neurosurgery, Spine and Spinal Cord Institute, Severance Hospital, Yonsei University College of Medicine, 50-1, Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea
2
Department of Neurosurgery, Hallym University Sacred Heart Hospital, 22, Gwanpyeong-ro 170 beon-gil, Dongan-gu, Anyang-si, Gyeonggi-do 14068, Republic of Korea
3
Swedish Neuroscience Institute in Seattle, Issaquah, WA, USA
cage materials (including the use of polyetheretherketone, allograft bone, and
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