Techniques for cervical interbody grafting

Timothy C. Ryken, Robert F. Heary, Paul G. Matz, Paul A. Anderson, Michael W. Groff, Langston T. Holly, Michael G. Kaiser, Praveen V. Mummaneni, Tanvir F. Choudhri, Edward J. Vresilovic, Daniel K. Resnick

Research output: Contribution to journalReview article

24 Citations (Scopus)

Abstract

Object. The objective of this systematic review was to use evidence-based medicine to determine the efficacy of interbody graft techniques. Methods. The National Library of Medicine and Cochrane Database were queried using MeSH headings and keywords relevant to cervical interbody grafting. Abstracts were reviewed and studies that met the inclusion criteria were selected. The guidelines group assembled an evidentiary table summarizing the quality of evidence (Classes I-III). Disagreements regarding the level of evidence were resolved through an expert consensus conference. The group formulated recommendations that contained the degree of strength based on the Scottish Intercollegiate Guidelines network. Validation was done through peer review by the Joint Guidelines Committee of the American Association of Neurological Surgerons/Congress of Neurological Surgeons. Results. Autograft bone harvested from the iliac crest, allograft bone from either cadaveric iliac crest or fibula, or titanium cages and rectangular fusion devices, with or without the use of autologous graft or substitute, have been successful in creating arthrodesis after 1- or 2-level anterior cervical discectomy with fusion (Class II). Alternatives to autograft, allograft, or titanium cages include polyetheretherketone cages and carbon fiber cages (Class III). Polyetheretherketone cages have been used successfully with or without hydroxyapatite for anterior cervical discectomy with fusion. Importantly, recombinant human bone morphogenic protein-2 carries a complication rate of up to 23-27% (especially local edema) compared with 3% for a standard approach. Conclusions. Current evidence does not support the routine use of interbody grafting for cervical arthrodesis. Multiple strategies for interbody grafting have been successful with Class II evidence supporting the use of autograft, allograft, and titanium cages.

Original languageEnglish (US)
Pages (from-to)203-220
Number of pages18
JournalJournal of Neurosurgery: Spine
Volume11
Issue number2
DOIs
StatePublished - Aug 1 2009

Fingerprint

Autografts
Titanium
Allografts
Diskectomy
Arthrodesis
Guidelines
Bone and Bones
Medical Subject Headings
National Library of Medicine (U.S.)
Transplants
Fibula
Peer Review
Evidence-Based Medicine
Durapatite
Edema
Consensus
Joints
Databases
Equipment and Supplies
Proteins

All Science Journal Classification (ASJC) codes

  • Surgery
  • Neurology
  • Clinical Neurology

Cite this

Ryken, T. C., Heary, R. F., Matz, P. G., Anderson, P. A., Groff, M. W., Holly, L. T., ... Resnick, D. K. (2009). Techniques for cervical interbody grafting. Journal of Neurosurgery: Spine, 11(2), 203-220. https://doi.org/10.3171/2009.2.SPINE08723
Ryken, Timothy C. ; Heary, Robert F. ; Matz, Paul G. ; Anderson, Paul A. ; Groff, Michael W. ; Holly, Langston T. ; Kaiser, Michael G. ; Mummaneni, Praveen V. ; Choudhri, Tanvir F. ; Vresilovic, Edward J. ; Resnick, Daniel K. / Techniques for cervical interbody grafting. In: Journal of Neurosurgery: Spine. 2009 ; Vol. 11, No. 2. pp. 203-220.
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Ryken, TC, Heary, RF, Matz, PG, Anderson, PA, Groff, MW, Holly, LT, Kaiser, MG, Mummaneni, PV, Choudhri, TF, Vresilovic, EJ & Resnick, DK 2009, 'Techniques for cervical interbody grafting', Journal of Neurosurgery: Spine, vol. 11, no. 2, pp. 203-220. https://doi.org/10.3171/2009.2.SPINE08723

Techniques for cervical interbody grafting. / Ryken, Timothy C.; Heary, Robert F.; Matz, Paul G.; Anderson, Paul A.; Groff, Michael W.; Holly, Langston T.; Kaiser, Michael G.; Mummaneni, Praveen V.; Choudhri, Tanvir F.; Vresilovic, Edward J.; Resnick, Daniel K.

In: Journal of Neurosurgery: Spine, Vol. 11, No. 2, 01.08.2009, p. 203-220.

Research output: Contribution to journalReview article

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T1 - Techniques for cervical interbody grafting

AU - Ryken, Timothy C.

AU - Heary, Robert F.

AU - Matz, Paul G.

AU - Anderson, Paul A.

AU - Groff, Michael W.

AU - Holly, Langston T.

AU - Kaiser, Michael G.

AU - Mummaneni, Praveen V.

AU - Choudhri, Tanvir F.

AU - Vresilovic, Edward J.

AU - Resnick, Daniel K.

PY - 2009/8/1

Y1 - 2009/8/1

N2 - Object. The objective of this systematic review was to use evidence-based medicine to determine the efficacy of interbody graft techniques. Methods. The National Library of Medicine and Cochrane Database were queried using MeSH headings and keywords relevant to cervical interbody grafting. Abstracts were reviewed and studies that met the inclusion criteria were selected. The guidelines group assembled an evidentiary table summarizing the quality of evidence (Classes I-III). Disagreements regarding the level of evidence were resolved through an expert consensus conference. The group formulated recommendations that contained the degree of strength based on the Scottish Intercollegiate Guidelines network. Validation was done through peer review by the Joint Guidelines Committee of the American Association of Neurological Surgerons/Congress of Neurological Surgeons. Results. Autograft bone harvested from the iliac crest, allograft bone from either cadaveric iliac crest or fibula, or titanium cages and rectangular fusion devices, with or without the use of autologous graft or substitute, have been successful in creating arthrodesis after 1- or 2-level anterior cervical discectomy with fusion (Class II). Alternatives to autograft, allograft, or titanium cages include polyetheretherketone cages and carbon fiber cages (Class III). Polyetheretherketone cages have been used successfully with or without hydroxyapatite for anterior cervical discectomy with fusion. Importantly, recombinant human bone morphogenic protein-2 carries a complication rate of up to 23-27% (especially local edema) compared with 3% for a standard approach. Conclusions. Current evidence does not support the routine use of interbody grafting for cervical arthrodesis. Multiple strategies for interbody grafting have been successful with Class II evidence supporting the use of autograft, allograft, and titanium cages.

AB - Object. The objective of this systematic review was to use evidence-based medicine to determine the efficacy of interbody graft techniques. Methods. The National Library of Medicine and Cochrane Database were queried using MeSH headings and keywords relevant to cervical interbody grafting. Abstracts were reviewed and studies that met the inclusion criteria were selected. The guidelines group assembled an evidentiary table summarizing the quality of evidence (Classes I-III). Disagreements regarding the level of evidence were resolved through an expert consensus conference. The group formulated recommendations that contained the degree of strength based on the Scottish Intercollegiate Guidelines network. Validation was done through peer review by the Joint Guidelines Committee of the American Association of Neurological Surgerons/Congress of Neurological Surgeons. Results. Autograft bone harvested from the iliac crest, allograft bone from either cadaveric iliac crest or fibula, or titanium cages and rectangular fusion devices, with or without the use of autologous graft or substitute, have been successful in creating arthrodesis after 1- or 2-level anterior cervical discectomy with fusion (Class II). Alternatives to autograft, allograft, or titanium cages include polyetheretherketone cages and carbon fiber cages (Class III). Polyetheretherketone cages have been used successfully with or without hydroxyapatite for anterior cervical discectomy with fusion. Importantly, recombinant human bone morphogenic protein-2 carries a complication rate of up to 23-27% (especially local edema) compared with 3% for a standard approach. Conclusions. Current evidence does not support the routine use of interbody grafting for cervical arthrodesis. Multiple strategies for interbody grafting have been successful with Class II evidence supporting the use of autograft, allograft, and titanium cages.

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Ryken TC, Heary RF, Matz PG, Anderson PA, Groff MW, Holly LT et al. Techniques for cervical interbody grafting. Journal of Neurosurgery: Spine. 2009 Aug 1;11(2):203-220. https://doi.org/10.3171/2009.2.SPINE08723