News Category: Cervical Spine

Fusion of the neck (cervical spine) is widely used to treat disc disease. There’s a problem with this treatment. Many patients get degenerative changes at the level just above or just below the fusion. It’s not clear if these changes are caused by increased motion or by the natural process of the disease already present. When the fused level doesn’t move, perhaps the load is passed up or down. The adjacent levels take on an added mechanical stress. Since disc disease is already present, researchers think both factors may add to the wear and tear on the nearby discs.

In this study 180 patients had neck fusion surgery. They were followed for more than five years. All patients were fused with a metal plate in front of the vertebral bone or bone graft to hold the spine in place until bone growth filled in. X- rays taken five years or more after the operation were compared to earlier X-rays taken right before or right after the surgery.

The researchers looked for disc height and any signs of degeneration. A loss of more than 50 percent of the disc height was scored as severe degeneration. A decrease of 50 to 75 percent was called moderate, and a loss of 25 percent of disc height was recorded as mild. Bone spurs were also graded as mild, moderate, or severe and used as a measure of surgery success.

The authors report that 92 percent of all patients had increased spine degeneration after fusion. The greater the time interval after the operation, the more damage was present. Age at the time of surgery didn’t seem to make a difference. Whether or not a plate was used to fuse the spine didn’t seem to make the changes worse. The researchers conclude that the need for reoperation will increase the more time goes by after fusion.

People with chronic neck pain from whiplash injury can have changes in their balance. Scientists in Denmark used a special platform to look at changes in foot position as a measure of balance or loss of balance. The postural recordings are part of a study called posturography.

Posturography was compared for two groups. The first group had a chronic whiplash injury. The second (control) group had no neck pain and no history of whiplash injury. Active neck motion and position sense were measured for both groups.

Researchers applied vibration to the Achilles tendons of all subjects. Then muscles in the neck were injected with a salt solution. Subjects were asked to talk and to open and close their eyes while standing. Posture recordings were taken for both groups after each event.

People in the control group made all the needed postural adjustments. Being pushed off balance, closing their eyes, talking, or painful injections didn’t prevent them from keeping their normal balance.

The researchers found decreased motion and reduced position sense in the whiplash group compared to the control group. The authors suggest these changes show a protective response in whiplash patients.

Postural control is altered after a whiplash injury. Damage to neck joints from the injury results in reduced position sense. There may be changes in the patient’s vision. Postural responses are slowed down because visual responses are slower, so muscle activity is slower. We rely on position sense and our inner ear mechanism to keep an upright position and our balance.

Knowing about these differences in the postural system after whiplash may help us find ways to treat chronic symptoms. Posturography may help us find patients with these changes.

The world is wild for soccer. Soccer can be a great life-long sport. Around the world, people play soccer from childhood to old age. That’s wonderful for overall fitness. But it may become a real pain in the neck, literally.

It is known that heading the ball too much can cause damage to the head and brain. These researchers from Turkey looked at whether soccer players also caused damage to the cervical spine (the spine in the neck). They looked at the cervical spine in 30 male soccer players and 30 regular guys. Everyone was tested for neck strength and range of motion. X-rays and MRI scans were also taken of the cervical spine.

Soccer players under age 30 had better neck strength and range of motion. However, that didn’t seem to help in the long run. Players over 30 had no more strength and worse range of motion than the control group. Worst of all, soccer players had more spinal degeneration in the neck than the control group. Soccer players over 30 showed much more degeneration. Degenerative changes included bulging discs, spinal cord compression, and bony growths in the spinal canal.

The authors believe that the intense forces from heading the ball damage the neck over time. The authors question whether strength training for the neck would help limit spinal degeneration. Only further research will tell for sure.

Ways to fuse the cervical spine (the spine in the neck) continue to improve as technology changes. A computer-assisted surgery (CAS) system is now in use.

Doctors in Germany report on their success using the CAS system. They used screws to hold the cervical vertebrae in place until the fusion was solid. Infrared cameras attached to the surgical tools gave the surgeons a clear view on a computer monitor during the operation.

There can be problems with this operation because of the small size of the bone where the screws go in. Damage to the nerves and blood vessels is possible. In this study, 19 patients had surgical screws inserted through the bones in the back part of the cervical spine. When the operation is done through the back of the neck, it is called posterior cervical fusion.

The advantage to using screws is the ability to reposition them. They also take less time to put in place. This makes the surgery shorter, with less blood loss. The CAS system measures the bone and chooses the right size of hole for the screw. The computer keeps the drill from going all the way through the bone.

The surgeons checked the position of the screws after surgery using images from a CT scan. None of the screws was misplaced. There were no injuries to the nerves, blood vessels, or bones. None of the screws had to be removed, replaced, or repositioned.

The CAS system has been in use for fusion of the low back since 1993. This study shows it can be used safely for posterior cervical fusion. The screws are placed in the right place without injury to the nearby structures. The authors conclude the CAS system makes a good spine surgeon even better.

Ever wonder how well seatbelts and airbags work? Do they really prevent neck injuries? Researchers at the University of Alabama report on this and more. Using information from the National Automotive Sampling System (NASS), they report:

There’s no doubt that the ligaments and joints in the neck are strained during a whiplash injury. The joints are pressed together, and they also slide back and forth. The ligaments are stretched to the straining point. The joints in the lower part of the neck take the biggest beating. The risk of injury is greatest as the speed of the neck movement increases.

These are the results of a study from Yale University School of Medicine. Engineers at the Biomechanics Research Lab studied the effects of whiplash forces on whole cervical spine specimens. Using six cadavers (human specimens saved for study), various impacts were placed on the neck. High-speed digital cameras were used to record the spinal motions during impact.

The researchers reported a maximum strain of 51 percent at the C5-C6 spinal level. The force was greater than the strength of the ligament, and injury occured. Rear-impact forces of 3.5 g or more caused damage to the joints. Joint sliding increased as the severity of the impact went up. Ligament strain at the next lower level (C6-C7) occurred at about 40 percent when the force was at 8 g.

This study supports the idea that neck pain after whiplash comes from joint and ligament strain. Compression of the joints in both the upper and lower neck takes place. This force is beyond what the normal joint can handle. A better understanding of how whiplash occurs will help us prevent such injuries and offer improved treatment when they do occur.

We’ve all seen someone who can’t move the neck after a whiplash injury. Pain and loss of motion are common in the early days after the injury. But why do some people end up with chronic pain and others don’t?

This is the focus of a new study from the Whiplash Research Unit in Australia. Research has shown changes in other parts of the spine after whiplash in patients with chronic pain. It’s thought that such changes only affect some patients. Studies also show that higher levels of pain and disability right after an accident may lead to chronic whiplash.

In this study, motor function, changes in sensory input, and psychological factors were measured. There were 80 whiplash patients included. The researchers looked for differences in the three measures among patients with mild, moderate, and severe pain.

All whiplash injuries occurred within the last 30 days. The injured patients were compared to a control group of 20 uninjured subjects. Range of motion and joint position error (JPE) were measured using a special device and custom computer program. JPE is the ability to return the head to its natural position after turning it from side to side or up and down. Other measures included pain, temperature, and psychological distress.

The results showed that all whiplash groups had less motion than the control group. The groups with moderate or severe symptoms had greater JPEs than the group with mild pain. All patients had psychological distress. But distress was greater after moderate and severe injuries. Motor or sensory changes weren’t related to psychological distress. The severely injured group was more limited socially. They also had more anxiety and trouble sleeping.

The authors conclude that changes occur in the nervous system and muscle activation soon after a whiplash injury. These changes are likely caused by injured structures in the head and neck. Patients with more severe pain seem to be more sensitive to these changes than those with mild symptoms. The changes in the nervous tissue, not psychological distress, account for more extreme symptoms in some people after a whiplash injury.

Do you wake up with neck pain or stiffness? You’re not alone. About one-third of adults under age 40 wake up with neck symptoms at least once a week. What’s going on? That’s what researchers in Australia are trying to find out.

Many studies have been done trying to link poor posture with neck pain. It makes sense that slumped sitting and forward head posture can cause neck pain. But scientists haven’t been able to pin the blame on posture. Too many people have these poor postures without neck pain.

In this study, physical therapists measured neck motion and muscle strength in 40 healthy adults between the ages of 19 and 42. They also looked at posture to see if there is any link between position and pain. All subjects in the study were free of pain and had not received any treatment for neck or back problems.

After testing, it turns out that 35 percent of these healthy young adults reported neck pain or discomfort more than once. These results match findings from other studies about how often neck pain occurs. The group with neck pain had less neck muscle endurance during testing. They also had less motion when turning their heads to the left and when tilting the head and neck back. There were no differences in posture between the group with neck pain and the group without symptoms.

The authors conclude that posture is not linked with neck symptoms. Other signs of impairment may be more important, such as decreased motion and muscle weakness. Perhaps the impairments in motion and strength are early signs that neck pain will develop later. The researchers expect to use this information to direct their next study of neck pain.

Steroid injections are often used to treat neck problems. Very rarely, a patient will have a problem after the treatment. Even more rarely, an inflamed area of pus (an abscess) forms. This is a case report of such an abscess. There has only been one other report of an abscess after epidural steroid injection published in the medical journals.

A 51-year-old male went to his doctor for left shoulder and neck pain. He also had some numbness and weakness of the left hand. An MRI showed a herniated disc at C4-C5. It didn’t get better after eight months, so the doctor injected the area with a steroid.

The patient had good relief from his symptoms for the first week. Then he developed neck and arm pain with fever and chills. Antibiotics were given for 10 days, but the patient was worse by the third week. He had extreme pain, muscle spasm, numbness, and weakness.

Another MRI showed an epidural abscess from C4 to C6. Pus and infection inside the lining of the spinal cord were putting pressure on the spinal cord itself. Immediate surgery was done to take the pressure off the spinal cord and clean out the infection.

The patient went home 10 days later and returned to work three months after the operation. There were mild symptoms of left hand numbness and weakness at the seven-month checkup. Muscle strength was normal.

Doctors aren’t sure what causes epidural abscess after a steroid injection in the neck area. They occur more often in the low back area. Maybe the smaller epidural space in the neck prevents infection. Maybe there are fewer blood vessels to the area so there’s less chance of a blood-borne infection.

The authors conclude that even though its occurrence is rare, making an early diagnosis of epidural abscess is important. Treatment before severe nerve damage occurs gives the patient the best result. In the neck, epidural abscesses are more dangerous because they can put pressure directly on the spinal cord. In the lumbar spine, an abscess may just affect the spinal nerves.

Sometimes neck pain and pressure on the spinal cord require surgery to remove bones in the cervical spine. One such operation is called a corpectomy. The front part of a section of the spinal column is removed. Bone is grafted to hold the spine in place. A metal plate may be used to support the column until the fusion takes hold.

Some studies show an increase of degenerative arthritis in the spine just above or below the corpectomy. Other studies don’t agree with this finding. There is some thought that increased internal stress occurs at the adjacent segments. This occurs as a result of a change in the load after corpectomy.

In this study, 44 patients had one- or two-level corpectomies. Doctors used MRI and X-rays to look at what happened at the next (adjacent) level. They compared the results with changes in a segment farther away (the control level). They called the control level the remote segment.

Symptoms improved in 43 of the 44 patients after the operation. There were no major changes in the discs for either the adjacent or remote segments. There was a decrease in the size of the spinal canal around the spinal cord at the adjacent level.

The authors report that degenerative changes occurred at adjacent levels in 75 percent of the patients after central corpectomy. They think changes in the spinal ligaments are more to blame for the decreased canal size. It’s likely that an increased load occurs from this factor rather than strain from lack of motion at the fused site. The authors base this theory on the fact that there was no major change in the disc height, which would be expected with increased loading.

Spinal fusion is usually done with bone graft material. The bone can be taken from the patient’s own hip or using bone donated by someone else. There are problems with bone grafts, so doctors are looking for ways to replace them. Various bone substitutes are being used. So are titanium cages. The authors of this study report the hidden dangers in using cage implants to fuse the cervical spine (neck).

When cages are used, the mesh implant is inserted between the vertebral bones. The cage can also replace the main body of a vertebra when part or all of it is removed. Cages help support the bones and keep the height of the spine the same. This is important in reducing pressure on spinal nerve roots and keeping the ligaments at the right tension.

Only a few studies have been done to look at the problems that come with cervical fusion using titanium cages. The authors of this report want to add to what we know about this method of treating a problem neck. In this study, cervical fusion was done from the front of the spine in 24 patients. This approach is called anterior fusion. The disc was removed in all the patients. Some or all of the front part of the vertebra was removed. The removed bone was ground up and placed inside the cages. The cages were put in place. A metal plate was attached to the front of the spine where the bone had been cut out.

The results were measured using patient reports of symptoms and X-rays. X-rays show the alignment of the cage, graft, and bones. The status of the fusion is also seen on X-rays. Any problems with the implants were also recorded. These included any movement, loosening, or breakage of the cage, plate, or screws.

The fusion rate was 96 percent, but it took an average of six months for a solid fusion to occur. Overall, symptoms were much improved after surgery. The authors conclude that titanium mesh cages work well for anterior cervical fusion. With the bone taken from the front of the vertebra, there’s no need to harvest bone from the hip. However, the cages tend to shift and sink and must be watched carefully.

Most medical research involves studying large numbers of patients. But sometimes a case is so unusual that doctors will report on just one patient. This is one of those articles. This case report describes the treatment for a 67-year-old man who had neck surgery. The problem began when degenerative changes in his cervical spine (neck) started putting pressure on the spinal cord. He first noticed pain in the left side of his neck and down his left arm. Then he began to lose coordination and strength in both arms.

After five years, he ended up having surgery to release pressure on the nerves. Parts of several vertebrae were removed. Those vertebrae were then fused together. Screws and a metal plate were used to hold the spine steady. Within a day of surgery, the man’s condition went downhill. He needed another surgery to relieve swelling and fuse another vertebra.

The patient’s condition still wasn’t good after the second surgery. He lived in a rehab center and improved a bit over the next two years. But he started developing pneumonia again and again. Fluids from his esophagus were somehow getting into his lungs. Tests showed that the metal plate used to fuse the cervical spine had torn a hole in the esophagus. Doctors closed the hole in his esophagus and changed the plates and screws in his spine.

This case is unusual for several reasons. Problems with screws and plates generally show up soon after surgery, not years later. Usually when plates or screws damage nearby structures, they broke or were placed incorrectly. But in this case, the plates and screws were in their proper position. Nothing had slipped or broken. The authors recommend that doctors check the esophagus if a patient with cervical spinal fusion has problems with pneumonia.

Scientists have numbered and mapped out all the nerves in the body. They know which parts of the body get which nerve connection. For example, nerves in the neck supply sensation and muscle contraction to the neck, chest, and arms. When a patient develops arm numbness and weakness, doctors can usually trace the cause by the location of the symptoms.

Paralysis of the deltoid muscle in the upper arm is usually caused by pressure on the C5 spinal nerve root. It is expected that problems with this nerve would occur from problems in the C4/5 level in the neck. In this study, however, doctors report finding deltoid paralysis with problems above and below the C4/5 level. Doctors also tracked peoples’ symptoms after surgery to take pressure off the nerve to the deltoid muscle.

All patients were tested for pain levels and muscle strength. X-rays and MRIs were done to find the cause of the pressure. The tests showed what level was compressed. Disc herniation and bone spurs were the most common problems. Surgery to remove these damaged tissues and to fuse the neck was done for all patients.

The patients all got relief and recovery from pain and paralysis after the operation. These results show that deltoid paralysis can occur with problems above or below the usual C4/5 level. The authors think differences occur in how and where spinal nerves go. They don’t follow the same path in everyone. This helps to explain why someone with problems at C3/4 or C5/6 could end up with problems in the C5 nerve going to the deltoid muscle.

Surgery is generally successful in restoring normal function. The authors advise early surgery to get the best results. They think the deltoid muscle does better if it hasn’t been paralyzed too long. Knowing that problems with the C5 nerve can be coming from one level above or below C4/5 can help doctors make the right diagnosis and offer the best treatment.

Neck 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.

Fusion surgery for the neck comes with complications. For example, there is the possibility that a screw will loosen, move, or break. Doctors need an accurate way to assess screw placement and results.

X-rays have been used and studied for this purpose. This is the first study to look at CT scans as a way to check on screws in the neck (cervical spine). CT scans are three-dimensional (3-D) and give the best detail of the bone. Screws are inserted to hold the bones together while fusion occurs. Putting screws through the part of the vertebra called the pedicle is the method used in this study.

The authors report concern over the use of pedicle screws in the cervical spine. The vertebrae are small in this part of the spine, and the pedicles are narrow. There isn’t much room for error. Arteries and nerves can easily be damaged. A screw in the wrong place can result in permanent paralysis or disability. On the other hand, pedicle screws are less likely to loosen and give greater strength than other screw placements.

Researchers used cadavers in a pilot study. (Cadavers are human bodies preserved after death for study.) A pilot study means it’s the first time something has been tried. Usually a small number of test subjects are used to see if it is going to work. If it is successful, a larger study is done after the pilot study.

In a previous study, screws were inserted into the cervical spine. For this study, each spine segment was scanned after the screws were in place. The CT scan gives a 3-D image in slices of various thicknesses. The researchers scanned each cadaver five times with different-sized slices. Radiologists read the CT scans as a success or failure for correct pedicle screw placement.

Then the specimens were opened up and the screws were looked at directly. A comparison was made between the results according to a CT scan and the actual results. Those reading the scans were correct between 50 and 74 percent of the time. Seeing the actual results compared to the CT scan gave the readers training.

In the second step of this study, a new set of cadaver cervical spines was used. Pedicle screws were inserted and CT scans taken. The readers improved to almost 90 percent accuracy. The authors report that slices of less than three millimeters give the best reading.

The authors conclude that CT scans can help show if pedicle screws are in good alignment. But it may be too soon to rely on CT images. The accuracy isn’t high enough yet. More studies and better training are needed. CT scans are only as good as the reader.

Fusion surgery for the neck comes with complications. For example, there is the possibility that a screw will loosen, move, or break. Doctors need an accurate way to assess screw placement and results.

X-rays have been used and studied for this purpose. This is the first study to look at CT scans as a way to check on screws in the neck (cervical spine). CT scans are three-dimensional (3-D) and give the best detail of the bone. Screws are inserted to hold the bones together while fusion occurs. Putting screws through the part of the vertebra called the pedicle is the method used in this study.

The authors report concern over the use of pedicle screws in the cervical spine. The vertebrae are small in this part of the spine, and the pedicles are narrow. There isn’t much room for error. Arteries and nerves can easily be damaged. A screw in the wrong place can result in permanent paralysis or disability. On the other hand, pedicle screws are less likely to loosen and give greater strength than other screw placements.

Researchers used cadavers in a pilot study. (Cadavers are human bodies preserved after death for study.) A pilot study means it’s the first time something has been tried. Usually a small number of test subjects are used to see if it is going to work. If it is successful, a larger study is done after the pilot study.

In a previous study, screws were inserted into the cervical spine. For this study, each spine segment was scanned after the screws were in place. The CT scan gives a 3-D image in slices of various thicknesses. The researchers scanned each cadaver five times with different-sized slices. Radiologists read the CT scans as a success or failure for correct pedicle screw placement.

Then the specimens were opened up and the screws were looked at directly. A comparison was made between the results according to a CT scan and the actual results. Those reading the scans were correct between 50 and 74 percent of the time. Seeing the actual results compared to the CT scan gave the readers training.

In the second step of this study, a new set of cadaver cervical spines was used. Pedicle screws were inserted and CT scans taken. The readers improved to almost 90 percent accuracy. The authors report that slices of less than three millimeters give the best reading.

The authors conclude that CT scans can help show if pedicle screws are in good alignment. But it may be too soon to rely on CT images. The accuracy isn’t high enough yet. More studies and better training are needed. CT scans are only as good as the reader.

More cars. More traffic. More accidents. More whiplash injuries. That sums up the state of affairs on roads in Sweden. Physical therapists want to see fewer cases of whiplash. Studying how injury occurs may help find safer car designs and construction. But until whiplash associated disorders (WAD) are a thing of the past, it would be good to know which treatments work best.

Physical therapists from Sweden studied the effects of early or late treatment using two different methods. Patients were divided into two early treatment groups and two late groups. Early treatment groups began therapy within three days of injury. Late treatment began two weeks later. Each of the two groups had either standard treatment or active intervention.

In this study, standard treatments included advice on activities and a pamphlet on how and when to move the neck. Movements involved raising up the shoulders, pulling the shoulders back, and all neck motions. Active treatment is usually based on early and repeated movements. A group of patients matched by sex and age, but without accident or injury, was used to compare to the whiplash patients.

Patients in all four groups were followed for three years. Pain level, neck range of motion, and sick leave were used as measurements. The authors report faster recovery for patients in the active treatment group. These patients used less sick leave, and their pain was reduced more than in the standard group.

The authors conclude that if active treatment is given, it should be done early rather than late. Standard treatment is better received later. They think early intervention may even prevent delayed symptoms common with WAD. This information will help physical therapists plan the best program and timing for patients with WAD.

Modern technology continues to open new doors of study for researchers. The study of neck injuries from car accidents is one such field. Until now, it’s been hard to see or show any actual change in the cervical spine after low-speed car accidents. Patients complain of painful symptoms, but X-rays and other imaging studies often don’t show anything.

The marriage of imaging and computers has made it possible to get a closer look. Researchers in Iceland compared two groups of patients with neck problems. The first group had chronic neck pain from whiplash after a car accident. The second group reported chronic neck pain of unknown cause. All patients were women between the ages of 16 and 48 years.

Digital radiography with computer analysis was used to look at neck motion at three levels in the spine of the neck (the cervical spine). Motion at each segment was measured and analyzed. More women in the whiplash group had excess motion. This extra motion is called hypermobility. The middle cervical spine was affected the most.

The researchers think that increased motion in the middle cervical spine after whiplash injury may be what leads to chronic pain. Knowing this, treatment aimed at the specific problem might bring better results. This study only looked at three levels of neck motion. We still don’t know if the changes seen occur right away or develop weeks to months later. The authors suggest more research is needed to compare all segments over time.

Early explorers navigated by the stars in the sky. Today navigational tools are often computer-assisted. Even in the operating room, doctors rely on computers to guide them.

This study compares the use of a surgical navigational system with the standard manual method. The navigational system includes a camera and computer together. These tools convert CT scanning data to three-dimensional images. This is called real time imaging.

The patients all had neck (cervical) problems that required fusion. Screws used to hold the spine in place were put in with a computer-assisted system. The doctor could see each step of the screw insertion in 3-D on a TV screen. The results were compared with patients having the same operation by hand.

There were no cases of nerve or blood vessel damage using the navigational system. Likewise, the screws didn’t punch too far through the bone. On the other hand, manual screw insertion had a 6.5 percent rate of complications.

The authors report this navigational system is a good tool for putting screws safely in the cervical spine. They conclude this study shows the computer-assisted surgery is more accurate with fewer complications. It can be used for patients with small or deformed pedicles. The pedicle is the column of bone where the screw is placed.

This was a small study with only 17 patients having computer-assisted navigational surgery. A larger study is planned next.

Spinal fusion isn’t new, but the materials used for fusion keep changing. Bone graft from the pelvis was once the standard. Problems with pain, fracture, and infection have led doctors to look elsewhere. Donated bone from the bone bank is an option. However, failure of the “borrowed” bone to heal is a problem for some patients. Bone substitute is also being studied.

In this report doctors used another source. They removed bone from the spine to fill mesh cages, which are inserted in place of the bone removed.
The FDA recently approved cages for fusion of the low back. Now doctors are trying the cages in the neck (cervical spine). Forty-five patients at the University of Texas and Southwestern Medical Center had a cervical corpectomy, a procedure to remove the front part of two or more bones in the neck. The surgery is done from the front of the neck.

The removed bone was packed inside mesh cages and the cages put in place of the bone. The leftover bone was placed along each side of the cage. Metal plates and screws were also used along the front of the fusion.

The results? All but one patient had a solid fusion without problems. The one failure had a bone fracture, the metal plate slipped, and the cage moved. A second operation was done later to repair the problems.

The authors present a new way to fuse the neck in cases of degenerative disease. Removing the vertebral body and replacing it with a titanium mesh cage can be done using the patient’s own bone. This method may replace the current operation using long solid bone grafts from the patient’s own body or from the bone bank.