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Lee CJ, Boody BS, Demeter J, et al. Long-Term Radiographic and Functional Outcomes of Patients With Absence of Radiographic Union at 2 Years After Single-Level Anterior Cervical Discectomy and Fusion. Global Spine J. 2019;10(6):741-747doi: 10.1177/2192568219874768.
Lee, C. J., Boody, B. S., Demeter, J., Smucker, J. D., & Sasso, R. C. (2020). Long-Term Radiographic and Functional Outcomes of Patients With Absence of Radiographic Union at 2 Years After Single-Level Anterior Cervical Discectomy and Fusion. Global spine journal, 10(6), 741-747. https://doi.org/10.1177/2192568219874768
Lee, Christopher J, et al. "Long-Term Radiographic and Functional Outcomes of Patients With Absence of Radiographic Union at 2 Years After Single-Level Anterior Cervical Discectomy and Fusion." Global spine journal vol. 10,6 (2020): 741-747. doi: https://doi.org/10.1177/2192568219874768
Lee CJ, Boody BS, Demeter J, Smucker JD, Sasso RC. Long-Term Radiographic and Functional Outcomes of Patients With Absence of Radiographic Union at 2 Years After Single-Level Anterior Cervical Discectomy and Fusion. Global Spine J. 2020 Sep;10(6):741-747. doi: 10.1177/2192568219874768. Epub 2019 Sep 16. PMID: 32707013; PMCID: PMC7383798.
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Global Spine J. 2020 Sep;10(6):741-747. doi: 10.1177/2192568219874768. Epub 2019 Sep 16.

Long-Term Radiographic and Functional Outcomes of Patients With Absence of Radiographic Union at 2 Years After Single-Level Anterior Cervical Discectomy and Fusion.

Global spine journal

Christopher J Lee, Barrett S Boody, Jaclyn Demeter, Joseph D Smucker, Rick C Sasso

Affiliations

  1. Indiana Spine Group, Carmel, IN, USA.

PMID: 32707013 PMCID: PMC7383798 DOI: 10.1177/2192568219874768

Abstract

STUDY DESIGN: Retrospective radiographic investigation.

OBJECTIVE: To evaluate the long-term radiographic and functional outcomes of patients in whom there is absence of radiographic union at 2 years after single-level anterior cervical discectomy and fusion (ACDF).

METHODS: Thirty-one patients were evaluated at standard postoperative time intervals per index trial protocol. Plain film radiographic fusion criteria at the arthrodesis level was defined as interspinous motion (ISM) <1 mm with corresponding motion at a non-arthrodesed superjacent level ISM ≥4 mm. Radiographs and functional outcome measures were acquired at each follow-up visit. Delayed union was defined as lack of radiographic union by 24 months.

RESULTS: Nine patients demonstrated radiographic evidence of delayed radiographic union at 24 months. Of those 9 patients, 5 patients demonstrated evidence of union during the follow-up period to 72 months. Despite the absence of radiographic union based on our criteria, 3 of the 4 remaining patients reported remarkable improvements in pain scores and functional outcomes.

CONCLUSIONS: The natural history of delayed union at 24 months after ACDF was still favorable despite the prolonged delay in union. The majority of patients (5 of 9) without radiographic union at 24 months did proceed to radiographic union by final follow-up. In addition, patients that did not meet our criteria for fusion maintained postoperative improvements in patient-reported outcome scores. In summary, our study patients undergoing a single-level ACDF with asymptomatic radiographic delayed union at 24 months can expect maintained improvements in postoperative patient-reported outcomes scores and can still progress to successful radiographic fusion.

Keywords: ACDF; arthrodesis; cervical; discectomy; pseudarthrosis; radiculopathy; reoperation; spondylosis

References

  1. Neurosurgery. 2002 Feb;50(2):229-36; discussion 236-8 - PubMed
  2. J Neurosurg Spine. 2013 Feb;18(2):154-60 - PubMed
  3. Acta Orthop Belg. 2006 Jun;72(3):342-6 - PubMed
  4. Spine (Phila Pa 1976). 2015 Jul 1;40(13):974-91 - PubMed
  5. World Neurosurg. 2018 Aug;116:e1047-e1053 - PubMed
  6. J Neurosurg Spine. 2018 Feb;28(2):140-148 - PubMed
  7. J Bone Joint Surg Am. 2014 Apr 2;96(7):557-63 - PubMed
  8. Spine (Phila Pa 1976). 2014 Dec 15;39(26):2143-7 - PubMed
  9. Spine J. 2019 Mar;19(3):469-475 - PubMed
  10. Spine J. 2008 May-Jun;8(3):436-42 - PubMed
  11. J Spinal Disord. 1996 Jun;9(3):202-6 - PubMed
  12. Spine (Phila Pa 1976). 2007 Dec 15;32(26):2980-4 - PubMed
  13. Asian Spine J. 2016 Aug;10(4):776-86 - PubMed
  14. Asian Spine J. 2018 Aug;12(4):691-696 - PubMed
  15. Spine (Phila Pa 1976). 2003 Jan 1;28(1):46-51 - PubMed
  16. Spine J. 2015 Sep 1;15(9):2016-27 - PubMed
  17. Global Spine J. 2018 Oct;8(7):739-750 - PubMed
  18. Spine (Phila Pa 1976). 2016 Jul 1;41(13):1075-83 - PubMed
  19. Clin Orthop Relat Res. 2016 May;474(5):1307-16 - PubMed
  20. Spine (Phila Pa 1976). 2018 Jan 1;43(1):E23-E28 - PubMed
  21. J Bone Joint Surg Am. 1993 Sep;75(9):1298-307 - PubMed
  22. PLoS One. 2013 Jun 24;8(6):e67408 - PubMed
  23. Spine (Phila Pa 1976). 2006 Jul 1;31(15):E503-6 - PubMed
  24. J Spinal Disord Tech. 2015 Mar;28(2):41-6 - PubMed

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