Cervical Interbody Cage Fixation through Microscope

Hiroshi Nakagawa, MD
Junichi Mizuno, MD
Han–Soo Chang, MD
Takeya Watabe, MD (Aichi, Japan)

Anterior fusion with autogenous iliac bone graft has been used for cervical spondylosis (CS) and ossification of the posterior longitudinal ligament (OPLL) for years, however various pitfalls have been raised. Threaded titanium cages for the cervical spine which became available recently could be one of the alternative methods to solve these problems. >From August 1997 to June 1999, 100 patients with CS and/or OPLL were treated by anterior fusion using titanium cages, BAK/C in 61, CCM in 36 and Novus CT in 3. The main symptoms were myelopathy in 83 (83%) and radiculopathy in 17. In CS, 56 patients with instability or prominent bilateral osteophyte received interbody cage fixation, at one level in 32 (57%) and at two levels in 24 (43%). Of 44 patients with segmental OPLL, 19 (43%) were operated on at one level, 21 (48%) at two levels, and 4 (9%) at three levels.

The entire procedure was performed under the operating microscope, and the cages were packed with bone chips from the vertebrae. Surgical results were satisfactory in more than 90% with a few complications. In conclusion, interbody cage fixation seemed to be an effective and promising method in anterior approach for segmental OPLL and cervical spondylosis with instability or prominent bilateral osteophyte. It provides instant stability of the cervical spine, and facilitates early ambulation, short hospital stay and early return to work.