Scripties UMCG - Rijksuniversiteit Groningen
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Long-term clinical outcome after anterior cervical discectomy with polymethylmethacrylate (PMMA) for cervical degenerative disease.

(2018) Sikkens, D. (Dennis)

Degeneration of the cervical spine can lead to neurological symptoms, caused by compression of the nerve root or the spinal cord, that require surgical intervention. Often, an anterior cervical discectomy with fusion (ACDF) is performed, usually with interposition of a cage. However, the use of a cage substantially increases health care costs. The polymer polymethylmethacrylate (PMMA) is a potential alternative to the cage, since it is cheap and easy to use. The reported high-occurrence of non-fusion in ACDF with PMMA is often seen as a drawback, however no correlation between ACD fusion and clinical outcome is found in literature. The notion that fusion is not the most important parameter for clinical outcome warrants more research on the use of PMMA in cervical surgery. In this retrospective cohort study, 90 patients were assessed, who underwent a mono-level ACDF with PMMA for symptomatic degenerative cervical disease, between 2007 and 2012. Patients filled out an online questionnaire, developed to assess clinical long-term outcome, complications and re-operation rates. The primary outcome measure was the Neck Disability Index (NDI), secondary outcome measures were the EQ-5D-5L and the re-operation and complication rates. The average NDI score at follow-up (mean 7.5 years) was 19.0 points ± 18.0 points. The complication rate was 10% and the re-operation rate was 8.8%. These rates were consistent with other studies on the surgical treatment of degenerative cervical disease with ACDF. This study provides evidence of a good long-term clinical outcome in patients who had surgery for degenerative cervical disease using PMMA as fusion material. Therefore, the results of this study suggest that the use of PMMA is a valid and favorable option for ACDF

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