Warning Issued about Stand-Alone Cervical CagesNeck fusion is tricky business. Doctors don't have one clear best choice for treatment. Painful symptoms can occur when the disc presses on a spinal nerve. Removing the disc and taking the pressure off the nerve is the standard approach. Part of the bone may be taken out, too. In many cases, a metal plate is attached to the front of the vertebra. The plate helps hold the spine stable until fusion is complete.
Doctors are trying a new way to fuse the cervical spine. After removing the disc material, a fusion cage filled with bone graft goes into the disc space. This helps fuse together the bones above and below the cage. In this study, researchers at McGill University in Canada report the results of their first eight patients operated on with a stand-alone cervical cage. Stand-alone means there's no other bone graft used around the cage and no metal plating.
The authors report poor results with cage subsidence occurring in more than half the patients. Subsidence is a shifting or moving of the cage. Sometimes the cage sinks down into the bone like an object sinking into sand. In one case, the cage even broke and had to be removed.
Although this study was small, the researchers issued a warning. Subsidence in cervical cage fusion is a major problem. They advise using extra measures to stabilize the spine. The interbody cage used with a metal plate across the front of the vertebra is a better treatment option than a stand-alone cage.
Erol Gercek, et al. Subsidence of Stand-Alone Cervical Cages in Anterior Interbody Fusion: Warning. In European Spine Journal. November/December 2003. Vol. 12. No. 6. Pp. 513-516.
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