We use cookies to understand how you use our site and to improve your experience. This includes personalizing content and advertising. To learn more, click here. By continuing to use our site, you accept our use of cookies. Cookie Policy.

Features Partner Sites Information LinkXpress
Sign In
Advertise with Us

Download Mobile App


ATTENTION: Due to the COVID-19 PANDEMIC, many events are being rescheduled for a later date, converted into virtual venues, or altogether cancelled. Please check with the event organizer or website prior to planning for any forthcoming event.

Surgical Method Could Be Game Changer for Patients with Degenerative Cervical Spine Disease

By HospiMedica International staff writers
Posted on 22 Apr 2022
Print article
Image: Researchers have developed a new surgical method for neck surgery (Photo courtesy of Florida Atlantic University)
Image: Researchers have developed a new surgical method for neck surgery (Photo courtesy of Florida Atlantic University)

Anterior cervical discectomy and fusion (ACDF) is a common type of neck surgery that involves removing a damaged disc to relieve pressure on the spinal cord or nerve root and thereby alleviate associated pain, numbness, weakness or tingling. The damaged disc is removed from between two vertebral bones along with simultaneous fusion surgery. The fusion involves placing a bone graft or “cage” and/or implants where the disc was originally located to stabilize and strengthen the area. The use of cages for ACDF is important postoperatively to the alignment of the cervical spine and to maintain the intervertebral disc height. Few studies, however, have examined the impact of the underlying cancellous or “spongy” bone contact with regards to handling large loads from the cage. Moreover, it is still not clear whether a cage with or without screws will be the best choice for long-term fusion as the micromotion or sliding distance and subsidence or penetration of the cage still take place repeatedly. Now, for the first time, researchers have evaluated the effect of the range of motion, cage migration and subsidence using variable angle screws.

For the study, the researchers at Florida Atlantic University (Boca Raton, FL, USA) developed five finite element models from a cervical spine model. The first model was an intact spine model, and the second model was an altered model with cage insertion and a 2-level static plate. The other three models were altered models with the same cage insertion and a 2-level dynamic plate. They compared ACDF cages with and without screws on the biomechanical characteristics of the human spine, implanted cage, and associated hardware by comparing the micro motion and subsidence. Results of the study showed that the cage-screw and anterior plating combination model has promising potential to reduce the risk of micro motion and subsidence of implanted cages in two or more level ACDFs. This method could increase the stiffness of the construct and reduce the incidence of clinical and fusion failure following ACDF, which in turn, could decrease the need for revision surgeries or supplemental posterior realignment.

According to the researchers, because of the biomechanical stability of the current construct, there has been no need for a rigid cervical collar, which is typically used by other surgeons. A lower screw rotational angle resulted in superior biomechanical performance and lower incidence of migration and subsidence compared with a higher rotational angle in multilevel applications, regardless of loading. The researchers believe the underlying mechanism may be due to the cage-screw bonded to the bone and the constrained bottom of C5 vertebra making it more rigid. Researchers demonstrated that the cage-screw was able to prevent subsidence in all loading scenarios better than the cage without screws.

“Anterior cervical discectomy and fusion is widely used to treat patients with spinal disorders, where the cage is a critical component to achieve satisfactory fusion results. The risk factors for cage migration are multifactorial and include patient factors, radiological characteristics, surgical techniques and postoperative factors,” said Frank Vrionis, M.D., senior author of the study and director of the Marcus Neuroscience Institute. “Our results showed that the plate used in our study provided directional stability and obtained excellent fusion, indicating promising clinical outcomes for patients with degenerative cervical spine disease.”

“Our research aims to develop a platform for next generation patient-specific spine surgery by combining intelligent image process, AI technology/machine learning, finite element simulation and 3D printing to help surgeons design a surgery plan for each patient,” added Chi-Tay Tsai, Ph.D., study co-author and a professor, FAU Department of Ocean and Mechanical Engineering , and director, FAU Spine Biomechanical Laboratory. “Our clinical and biomechanical data have shown that the outcomes with the rigid static plate are very good. The main reason may be due to greater contact area between the cortical and cancellous bone in the cage-screw than that in unanchored cage constructs.”

Related Links:
Florida Atlantic University 

Print article



view channel
Image: ‘Hologram patients’ developed to help train doctors and nurses (Photo courtesy of University of Cambridge)

Life-Like Hologram Patients Train Doctors for Real-Time Decision Making in Emergencies

A medical training project using 'mixed reality' technology aims to make consistent, high-level and relevant clinical training more accessible across the world. University of Cambridge (Cambridge, UK)... Read more

Critical Care

view channel
Image: New device could provide alternative to opioids and other highly addictive drugs (Photo courtesy of Northwestern University)

Dissolving Implantable Device Can Manage Post-Operative Pain Without Drugs

Researchers have developed a small, soft, flexible implant that relieves pain on demand without the use of drugs. The first-of-its-kind device could provide a much-needed alternative to opioids and other... Read more

Patient Care

view channel
Image: The biomolecular film can be picked up with tweezers and placed onto a wound (Photo courtesy of TUM)

Biomolecular Wound Healing Film Adheres to Sensitive Tissue and Releases Active Ingredients

Conventional bandages may be very effective for treating smaller skin abrasions, but things get more difficult when it comes to soft-tissue injuries such as on the tongue or on sensitive surfaces like... Read more

Health IT

view channel
Image: AI can reveal a patient`s heart health (Photo courtesy of Mayo Clinic)

AI Trained for Specific Vocal Biomarkers Could Accurately Predict Coronary Artery Disease

Earlier studies have examined the use of voice analysis for identifying voice markers associated with coronary artery disease (CAD) and heart failure. Other research groups have explored the use of similar... Read more


view channel
Image: Expanding the role of autonomous robots can mitigate the shortage of physicians (Photo courtesy of Pexels)

Robot-Assisted Surgical Devices Market Driven by Increased Demand for Patient-Specific Surgeries

An aging population and accompanying retirements will cause a significant physician shortfall of 55,000 to 150,000 by 2030, creating a gap in the healthcare system. Expanding the role of autonomous robots... Read more
Copyright © 2000-2022 Globetech Media. All rights reserved.