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Conference Paper: Anterior cervical discectomy and fusion for cervical myelopathy using standalone tricortical iliac crest autograft: predictive factors for neurological and fusion outcomes
Title | Anterior cervical discectomy and fusion for cervical myelopathy using standalone tricortical iliac crest autograft: predictive factors for neurological and fusion outcomes |
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Authors | |
Issue Date | 2019 |
Publisher | The Hong Kong Orthopaedic Association. |
Citation | 39th Annual Congress of the Hong Kong Orthopaedic Association 2019, Hong Kong, 2–3 November 2019 How to Cite? |
Abstract | Purpose: To investigate the outcomes after anterior cervical discectomy and fusion (ACDF) surgery with standalone tricortical iliac crest autograft and to determine predictive factors for poor neurological recovery, non-union, graft collapse, and loss of C2-7 sagittal alignment.
Methods: This was a retrospective study involving patients with cervical myelopathy who underwent ACDF surgery with standalone tricortical iliac autograft between 2006 and 2016, minimum 2-year postoperative follow-up. Outcomes included the change in Japanese Orthopaedic Association (JOA) scores clinically and timing of fusion, graft height and C2-7 angle measured on lateral radiographs. Any complications such as neurological deterioration, non-union, graft collapse or loss of angle were recorded. Delayed union was considered as radiological union identified only beyond postoperative 6-months. Risk factors including age, smoking, drinking, comorbidities and operative levels were analysed through a multivariate regression for their respective influences on the various outcomes.
Results: Of the 69 patients studied, none of the patients had non-union while 33 (47.1%) achieved fusion in 6 months. The most common complications were anterior protrusion of graft (5.8%) and hoarseness (2.9%). The 1-year mean change in JOA score was 3.9 (standard deviation=2.7). The C2-7 angle gradually became more kyphotic despite an initial lordosis correction intra-operatively. The graft height also gradually collapsed during subsequent follow-up examinations. Multivariate regression model suggested that diabetics (cumulative odds ratio: 7.4) and drinkers (cumulative odds ratio: 8.6) were associated with delayed union.
Conclusion: The ACDF using tricortical iliac crest autograft has satisfactory outcomes with low occurrence of complications. Diabetes and regular alcohol consumption were predictors of delayed fusion. |
Description | Free Paper Session III: Spine - no. FP3.13 |
Persistent Identifier | http://hdl.handle.net/10722/279698 |
DC Field | Value | Language |
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dc.contributor.author | Chung, MMT | - |
dc.contributor.author | Yeung, KKL | - |
dc.contributor.author | Cheung, WHP | - |
dc.contributor.author | Cheung, JPY | - |
dc.date.accessioned | 2019-12-09T06:44:36Z | - |
dc.date.available | 2019-12-09T06:44:36Z | - |
dc.date.issued | 2019 | - |
dc.identifier.citation | 39th Annual Congress of the Hong Kong Orthopaedic Association 2019, Hong Kong, 2–3 November 2019 | - |
dc.identifier.uri | http://hdl.handle.net/10722/279698 | - |
dc.description | Free Paper Session III: Spine - no. FP3.13 | - |
dc.description.abstract | Purpose: To investigate the outcomes after anterior cervical discectomy and fusion (ACDF) surgery with standalone tricortical iliac crest autograft and to determine predictive factors for poor neurological recovery, non-union, graft collapse, and loss of C2-7 sagittal alignment. Methods: This was a retrospective study involving patients with cervical myelopathy who underwent ACDF surgery with standalone tricortical iliac autograft between 2006 and 2016, minimum 2-year postoperative follow-up. Outcomes included the change in Japanese Orthopaedic Association (JOA) scores clinically and timing of fusion, graft height and C2-7 angle measured on lateral radiographs. Any complications such as neurological deterioration, non-union, graft collapse or loss of angle were recorded. Delayed union was considered as radiological union identified only beyond postoperative 6-months. Risk factors including age, smoking, drinking, comorbidities and operative levels were analysed through a multivariate regression for their respective influences on the various outcomes. Results: Of the 69 patients studied, none of the patients had non-union while 33 (47.1%) achieved fusion in 6 months. The most common complications were anterior protrusion of graft (5.8%) and hoarseness (2.9%). The 1-year mean change in JOA score was 3.9 (standard deviation=2.7). The C2-7 angle gradually became more kyphotic despite an initial lordosis correction intra-operatively. The graft height also gradually collapsed during subsequent follow-up examinations. Multivariate regression model suggested that diabetics (cumulative odds ratio: 7.4) and drinkers (cumulative odds ratio: 8.6) were associated with delayed union. Conclusion: The ACDF using tricortical iliac crest autograft has satisfactory outcomes with low occurrence of complications. Diabetes and regular alcohol consumption were predictors of delayed fusion. | - |
dc.language | eng | - |
dc.publisher | The Hong Kong Orthopaedic Association. | - |
dc.relation.ispartof | 39th Annual Congress of the Hong Kong Orthopaedic Association 2019 | - |
dc.title | Anterior cervical discectomy and fusion for cervical myelopathy using standalone tricortical iliac crest autograft: predictive factors for neurological and fusion outcomes | - |
dc.type | Conference_Paper | - |
dc.identifier.email | Cheung, WHP: gnuehcp6@hku.hk | - |
dc.identifier.email | Cheung, JPY: cheungjp@hku.hk | - |
dc.identifier.authority | Cheung, JPY=rp01685 | - |
dc.identifier.hkuros | 308657 | - |
dc.publisher.place | Hong Kong | - |