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A Comparative Study Between the Functional and Radiological Outcomes of ACDF Using Locking Stand Alone Cage And Anterior Cervical Plate With Titanium Disc Cage in Degenerative Cervical Spine Disease

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Vol. 10 | Issue 1 | January-February 2022 | Page: 15-21 | HS Chandrashekar, Mohan N S, Ashwin S, Syed Farhan Bukhari, Nithin S M

DOI:10.13107/jkoa.2022.v10i01.046

Authors: HS Chandrashekar [1], Mohan N S [1], Ashwin S [1], Syed Farhan Bukhari [1], Nithin S M
[1]

[1] Department of Orthopaedics, Sanjay Gandhi Institute of Trauma and Orthopaedics, Bangalore, Karnataka, India.

Address of Correspondence

Dr. Ashwin S,
Department of Orthopaedics, Sanjay Gandhi Institute of Trauma and Orthopaedics, Bangalore, Karnataka, India.
E-mail: ashwinsuresh47@gmail.com

Abstract

Background: Cervical spondylotic radiculopathy and myelopathy are common problems for which anterior cervical discectomy and fusion is a gold standard procedure. There are various implant options available, two of which are commonly used in practice. Anterior cervical cage with plate and locking standalone cage. Our study aims to compare these two methods to know the functional and radiological outcomes after Anterior cervical discectomy and fusion procedure.
Materials and Methods: We performed a prospective comparative study of 60 patients with single or two level degenerative cervical spine disease with failed conservative management. They were divided randomly into 2 groups of 30 patients each one group treated using locking standalone cage and the other with anterior cervical plate with cage using Smith Robinson approach. The clinical outcome was measured using visual analogue scores, Robinson’s criteria and Neck disability index and the radiological outcome was assessed using cobb’s angle, segmental height and segment angle with a follow up period of 2 years.
Results: At 2 years follow up, good functional outcomes were obtained in both implant groups in terms of Robinson criteria, neck disability index and visual analogue scale. And good radiological outcomes were obtained in both implant groups with 93.3% fusion rates in both groups. Significant dysphagia was seen in the cage with plate group(26.6%) and significant cage subsidence was noted in the standalone cage group(20%).
Conclusion: The functional and radiological outcomes are superior at 2 years follow up in both implant groups. Hence standalone cage and cage with plate technique both are equally safe and effective treatment options in 1 or 2 level degenerative cervical spine disease.
Keywords: Anterior cervical discectomy and fusion, Neck Disability Index, Visual Analogue scale, Locking standalone cage, Anterior cervical plate, cage subsidence, Robinson criteria.

References

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How to Cite this article:  Chandrashekar HS, Mohan NS, Ashwin S, Bukhari SF, Nithin SM | A Comparative Study Between the Functional and Radiological Outcomes of ACDF Using Locking Stand Alone Cage And Anterior Cervical Plate With Titanium Disc Cage in Degenerative Cervical Spine Disease | Journal of Karnataka Orthopaedic Association | January-February 2022; 10(1): 15-21.

 

 

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A Study to Assess the Functional Outcome After Laminotomy and Microdiscectomy in Lower Lumbar Disc Prolapse

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Volume 6 | Issue 2 | May-Aug 2018 | Page 12-15 | Deepak Hegde, Arjun Ballal, Hishanil Rasheed

Authors: Deepak Hegde [1], Arjun Ballal [2], Hishanil Rasheed [1].

[1] Department of Orthopaedics, K.S Hegde Medical Academy, Mangalore – 575 018, Karnataka, India,

[2] Department of Orthopaedics, Consultant Orthopaedic Surgeon, Ballal Healthcare, Udupi – 576 105, Karnataka, India.

Address of Correspondence
Dr. Deepak Hegde,

Department of Orthopaedics, K.S Hegde Charitable Hospital,

Medical sciences Complex, Deralkatte, Mangalore – 575 018, Karnataka, India.

E-mail: arjchess_lp@rediffmail.com

Abstract

Background: Advances in technology with better surgical techniques and instrumentation have proved time and again to reduce the incidence of complications and cosmetic morbidities caused by the traditional techniques in the management of intervertebral disc prolapse of the lumbar spine. By limiting the width of the surgical corridor the risk of muscle crush, exposure of soft tissues for infection and post-operative morbidity and complications can be minimized by great amounts.

Aims and Objectives: The aim of the study was to assess the functional outcome of the spine after laminotomy and microdiscectomy in cases of lower lumbar intervertebral disc prolapse.

Materials and Methods: A prospective study was conducted in the department of orthopedics of a teaching hospital in Southern India. A total of 28 diagnosed cases of intervertebral disc prolapse at L5-S1 levels were included in the study. The preoperative functional status was assessed as per the modified oswestry disability index (ODI) and visual analog scale (VAS). All of them underwent laminotomy of L5 vertebra and microdiscectomy at L5-S1 level. The patients were reviewed at postoperative weeks 6, 12, and 24 and the functional status of the spine was assessed and tabulated using the modified ODI and VAS. All results were tabulated and calculated with repeated measures ANOVA using SPSS software version 20.0.

Results: It was noted that the modified ODI scores preoperatively had a mean of 75 ± 11.85% which improved to 55 ± 9.18% at 6 weeks, 45 ± 9.37% at 12 weeks, and 36 ± 8.65% at 24 weeks. The VAS scores were noted to have a mean of 8 ± 0.93 mm preoperatively. It was noted to have improved to 6 ± 0.93 mm at 6 weeks, 5 ± 0.74 mm at 12 weeks, and then to 5 ± 0.73 mm at 24 weeks. This showed that there was an improvement in the back function after surgery in all the cases. No complications were noted in any of the cases.

Conclusion: Laminotomy and microdiscectomy level is an excellent technique of management of intervertebral disc prolapsed of L5-S1 with minimal complication rate.

Keywords:  Visual analogue scale, Oswestry Disability Index, lumbar spine, laminotomy, microdiscectomy.

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How to Cite this article: Kulkarni M S, Fahim S M, Naik M, Vijayan S, Shetty S, Rao S K. Outcome Analysis of Osteosynthesis of Complex Fractures of Both Bones of Forearm. J Kar Orth Assoc. MayAug 2018; 6(2):12-15.

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