Neck Fusion: What Methods Work Best?Ever wonder what goes through the mind of some scientists? It's often more than the average person can follow, but sometimes the results can still benefit us. These researchers in Rhode Island asked three questions they wanted to see answered.
Their work centered on the best way to fuse the neck. Bone graft, bone graft with a metal plate, a supportive cage between the bones, and cage with a plate were all compared.
Here's what the researchers looked for:
The research was done on cadaver spines (bodies preserved after death for study). Loads were applied using a system of cables and pulleys. Different motions were tested including forward and backward bending, side bending, and rotation.
The results were not all clear cut. For example, graft alone and cage alone reduced joint range of motion, but not the length of the ligaments. The cage alone was slightly better than the graft alone in reducing angled motions. This makes for a stiffer neck, which is one goal of fusion surgery. In both groups adding a plate also reduced motion. Plates at two spinal levels gave the neck more stability than a plate only at one level.
The authors concluded that the cage is as good as a wedge of bone graft with fewer complications for neck fusions. The cage is slightly better at limiting neck side bending than the bone graft. Adding one or more metal plates to either the cage or the bone graft increases overall stability.
David L. Greene, MD, et al. Biomechanical Comparison of Cervical Interbody Cage Versus Structural Bone Graft. In The Spine Journal. July/August 2003. Vol. 3. No. 4. Pp. 262-269.
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