A Prospective Study of Interbody Fat Graft Application With the Anterior Contralateral Cervical Microdiscectomy to Preserve Segmental Mobility

Neurosurgery. 2017 Oct 1;81(4):627-637. doi: 10.1093/neuros/nyx056.

Abstract

Background: Any surgical procedure aims at protecting mobile segments at the operated level, and the sagittal balance of the columna vertebralis. Interbody fusion has become an often applied technique in anterior cervical discectomy.

Objective: To indicate that a minimally invasive technique in which we use interbody fat graft placement showed great results and effectiveness, especially in patients who were suffering from cervical paramedian disc herniation.

Methods: In this study, 432 patients were observed from 2000 to 2013. All these consecutive patients had paramedian disc herniation. The initial 239 patients (group 1) underwent microdiscectomy without graft placement, whereas the remaining 193 patients (group 2) had a microdiscectomy with interbody fat graft insertion. The Neck Disability Index (NDI) and Short Form-36 (SF-36) were used to evaluate clinical outcomes. They were followed up for 5.3 years (range 2-13 years).

Results: Spontaneous radiological fusion was noticed in 12% of group 1 patients and none of the group 2 patients. It has been observed that the mean overall cervical curvature (C2-7) angles and segmental lordosis did not change significantly in late follow-up findings. During both early and late follow-ups, all patients indicated a decreasing NDI score, but in late follow-up, an improving SF-36 score.

Conclusion: This surgical technique provides good direct decompression and preserves mobility at the treated level, while preventing disc collapse.

Keywords: Anterior cervical discectomy; Contralateral approach; Fat graft; Kyphosis; Spinal alignment.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Cervical Vertebrae / diagnostic imaging*
  • Cervical Vertebrae / surgery*
  • Decompression, Surgical / methods
  • Diskectomy / methods*
  • Female
  • Follow-Up Studies
  • Humans
  • Intervertebral Disc Displacement / diagnostic imaging*
  • Intervertebral Disc Displacement / surgery*
  • Lordosis / diagnostic imaging
  • Lordosis / surgery
  • Male
  • Microsurgery / methods
  • Middle Aged
  • Neurosurgical Procedures
  • Prospective Studies
  • Spinal Fusion / methods
  • Subcutaneous Fat / transplantation*
  • Tissue Transplantation / methods
  • Treatment Outcome