In gratitude of the loyal support of our members, the CNS is offering complimentary 2021 Annual Meeting registration to all members! Learn more.

  • Minimally Disruptive Posterior Cervical Fusion with DTRAX Cervical Cage for Single Level Radiculopathy - Results in 10 Patients at 1-Year

    Final Number:
    1390

    Authors:
    Bruce M. McCormack MD (1); Leo W. K. Cheng MD (2); Edward F. Eyster MD (1); John C. Chiu MD (3)

    Study Design:
    Clinical Trial

    Subject Category:

    Meeting: Congress of Neurological Surgeons 2015 Annual Meeting

    Introduction: The authors present one-year results of 10 patients with cervical radiculopathy due to spondylosis and stenosis treated with a minimally disruptive posterior cervical fusion. DTRAX Cervical Cage is a titanium intervertebral cage that was used to distract and immobilize the cervical facet to achieve indirect root decompression and fusion. Clinical and radiologic results are analyzed.

    Methods: A one-year retrospective study of 10 patients treated with DTRAX Cervical Cage was conducted. Neck Disability Index (NDI), Visual Analog Scale (VAS) for neck and arm pain, neurological status, adverse events, x-rays and CT were collected. X-rays were reviewed for segmental and overall cervical lordosis, fusion, and device retention. CT with reconstructions was obtained at one year in all patients.

    Results: All patients were available for follow-up at one year. Age ranged from 51 to 78 with a mean of 68. Five patients were treated at C5-6, four at C6-7, and one at C4-5. NDI and VAS were significantly improved immediately after surgery and sustained at one year. All patients had successful radiographic fusion defined as 1.5 mm or less change in distance between adjacent spinous processes at treated level on lateral flexion/extension radiographs. Bridging bone on CT was present in 9 with 1 indeterminate for fusion. There was no significant change in overall cervical lordosis or segmental lordosis. There were no device breakages, device back out, or surgical re-interventions.

    Conclusions: Minimally disruptive posterior cervical fusion with DTRAX Cervical Cage appears to be a safe and effective method of treating select patients with cervical radiculopathy as a result of spondylosis and foraminal stenosis.

    Patient Care: Reduce arm & neck pain and decrease post-op hospital stay through tissue sparing posterior cervical procedure.

    Learning Objectives: • One-year retrospective study of 10 patients treated with DTRAX Cervical Cage • Five patients were treated at C5-6, four at C6-7, and one at C4-5 • All patients had successful radiographic fusion defined as 1.5 mm or less change in distance between adjacent spinous processes at treated level on lateral flexion/extension radiographs • Bridging bone on CT was present in 9 with 1 indeterminate for fusion • There was no significant change in overall cervical lordosis or segmental lordosis

    References: 1. U.S. Food and Drug Administration: Summary of Safety and Effectiveness Data. Silver Spring, MD: U.S. Food and Drug Administration, 2012 (http://www.accessdata.fda.gov/cdrh_docs/pdf10/p100012b.pdf) [Accessed January 29, 2013] 2. Christensen KD, Buswell K: Chiropractic Outocmes Managing Radiculopathy in a Hospital Setting: A Retrospective Review of 162 Patients. J Chiropractic Med 7:115-125, 2008 3. Chung TS, Lee YJ, Kang SW, Park CJ, Kang WS, Shim YW: Reducibility of Cervical Disk Herniation: Evaluation At Mr Imaging During Cervical Traction With a Nonmagnetic Traction Device. Radiology 225:895-900, 2002 4. Constantoyannis C, Konstantinou D, Kourtopoulos H, Papadakis N: Intermittent Cervical Traction for Cervical Radiculopathy Caused By Large-Volume Herniated Disks. J Manipulative Physiol Ther 25:188-192, 2002 5. Fountas KN, Kapsalaki EZ, Nikolakakos LG, Smisson HF, Johnston KW, Grigorian AA, et al.: Anterior Cervical Discectomy and Fusion Associated Complications. Spine 32:2310-2317, 2007 6. Goel A, Shah A: Facetal Distraction as Treatment for Single-and Multilevel Cervical Spondylotic Radiculopathy and Myelopathy: A Preliminary Report. J Neurosurg Spine 14:689-696, 2011 7. Grochulla F: Anterior Cervical Discectomy and Fusion, in Vieweg U, Grochulla F (ed): Manual of Spine Surgery. Springer Berlin Heidelberg, 2012, pp 127-133 8. Hilibrand AS, Carlson GD, Palumbo MA, Jones PK, Bohlman HH: Radiculopathy and Myelopathy At Segments Adjacent to the Site of a Previous Anterior Cervical Arthrodesis. Journal of Bone & Joint 81:519-528, 1999 9. Hilibrand AS, Robbins M: Adjacent Segment Degeneration and Adjacent Segment Disease: The Consequences of Spinal Fusion? Spine 4:190S-194S, 2004 10. Jellad A, Salah ZB, Boudokhane S, Migaou H, Bahri I, Rejeb N: The Value of Intermittent Cervical Traction in Recent Cervical Radiculopathy. Phy Rehab Med 52:638-652, 2009 11. Liu J, Ebraheim NA, Sanford CG, Patil V, Elsamaloty H, Treuhaft K, et al.: Quantitative Changes in the Cervical Neural Foramen Resulting From Axial Traction: In Vivo Imaging Study. Spine 8:619-623, 2008 12. McCormack BM, Bundoc RC, Ver MR, Ignacio JM, Berven SH, Eyster EF: Percutaneous Posterior Cervical Fusion With the Dtrax Facet System for Single-Level Radiculopathy: Results in 60 Patients. J Neurosurg Spine 18:245-254, 2013 13. Panjabi MM, Oxland T, Takata K, Goel V, Duranceau J, Krag M: Articular Facets of the Human Spine. Spine 18:1298-1310, 1993 14. Riley LH, Vaccaro AR, Dettori JR, Hashimoto R: Postoperative Dysphagia in Anterior Cervical Spine Surgery. Spine 35:S76-S85, 2010 15. Ruetten S, Komp M, Merk H, Godolias G: Full-Endoscopic Cervical Posterior Foraminotomy for the Operation of Lateral Disc Herniations Using 5.9-Mm Endoscopes. Spine 33:940-948, 2008 16. Sari H, Akarirmak U, Karacan I, Akman H: Evaluation of Effects of Cervical Traction on Spinal Structures By Computerized Tomography. Adv Physiotherapy 5:114-121, 2003 17. Seo M, Choi D: Adjacent Segment Disease after Fusion for Cervical Spondylosis; Myth or Reality? British Journal of Neurosurgery 22:195-199, 2008 18. Tan L, Gerard CS, Anderson PA, Traynelis VC: Effect of machined interfacet allograft spacers on cervical foraminal height and area. J Neurosurg Spine 20:178-182, 2014

We use cookies to improve the performance of our site, to analyze the traffic to our site, and to personalize your experience of the site. You can control cookies through your browser settings. Please find more information on the cookies used on our site. Privacy Policy