MRI and clinical course after anterior cervical decompression and fusion: A prospective two years longitudinal evaluation showing fibrous union of the bovine graft
1999 (English)In: Neuro-Orthopedics, ISSN 0177-7955, Vol. 26, no 1, 19-31 p.Article in journal (Refereed) Published
Study design. Twenty-five consecutive patients were studied prospectively after one-level anterior cervical decompression and fusion according to Cloward with bovine bone graft. Objectives. To monitor, by MRI, the postoperative changes at the fused and adjacent levels together with the longitudinal clinical course. Summary of background data. MRI has become the primary preoperative examination of cervical disc disease/spondylosis, but experience of the normal postoperative findings is still limited. Methods. MRI was performed preoperative and after three days, three six, 12 and 24 months accompanied with clinical reviews. Results. Up to six months postoperatively, the surgical debris behind the bone dowel was impossible to distinguish from remaining parts of osteophytes or disc fragments. A rim sign was permanent with high signal around but only slight enhancement in the bone transplant after i.v. contrast. Twelve patients had foraminal stenosis at the operated level, but only two of them had radicular pain. There was small amounts of epidural scar tissue. Four patients developed a severe degeneration at the adjacent levels, all of which had had some changes preoperatively. Clinically, we found improvement in muscle strength and sensory function, lowered pain rating (VAS) and 19 patients experience a good outcome. Three to six months postoperatively there was a period with some recurrence of symptoms. Conclusions. The decompression by an anterior procedure should not be evaluated by MRI until at least three months postoperatively. Asymptomatic foraminal stenosis was common postoperatively. The bovine xenograft (SurgiboneR) had a fibrous healing. The clinical results were satisfactory as evaluated by an unbiased observer.
Place, publisher, year, edition, pages
1999. Vol. 26, no 1, 19-31 p.
Cervical vertebrae, Magnetic resonance imaging, Prospective studies, Spinal fusion, Transplantation heterologous
Medical and Health Sciences
IdentifiersURN: urn:nbn:se:liu:diva-79468OAI: oai:DiVA.org:liu-79468DiVA: diva2:542560