Early results of one-level cervical discectomy and fusion with stand-alone cervical cage and bone marrow soaked tricalcium phosphate

Published online: Apr 27 2011

Shankar Acharya, Sameer Kumar, Abhishek Srivastava, Rushma Tandon

From Northern Railways Central Hospital, New Delhi, India


Cervical disc prolapse has been traditionally treated with anterior discectomy and fusion, with good results ; however autogenous bone graft and instrumentation remain a limiting factor. To avoid this, a stand-alone cage with bone marrow soaked tricalcium phosphate was used for single level cervical disc disease. Fifteen consecutive patients with single level cervical disc disease operated with the above technique were prospectively followed at six weeks, six and twelve months post-surgery. Clinical improvement was assessed by VAS and Odom's criteria. CT and plain radiography were used to assess fusion. Mean duration of symptoms was 7.2 months (SD : 4.14, range : 1-18 months). Mean preoperative VAS was 7 (SD : 1.31, range : 5-10) which improved to 1.4 (SD : 0.63, range : 1-3) at 6 weeks post op, 0.93 (SD : 0.80, range : 0-3) at 6 months and 0.80 (SD : 0.77, range : 0-3) at final follow-up. Similarly Odom's criteria were excellent in ten, good in three and satisfactory in 2 patients at six weeks. Results were rated excellent in eleven patients, good and satisfactory in two patients each respectively at six months and final follow-up. All patients had radiological fusion with no sign of cage extrusion. Results with this technique in terms of fusion, pain relief and overall functional outcomes were found to be good in this small patient population and warrant a larger sample size randomized long-term study.