Anterior cervical discectomy and fusion with Scarlet AC-T cervical secured cage. Safety evaluation and 6 months radiological follow up

Patrick Fransen

Acta Orthopaedica Belgica, 2019

Fusion rates in ACDF procedures with classical cages are higher if supplemented with a plate. However, the use of plates has been associated with increased morbidity and dysphagia. As an alternative, we studied the ACDF approach using, a secured titanium cage with integrated fixation screws, which allows for “Zero Profile” segmental stabilization.

We performed a retrospective analysis of prospectively collected data on a group of 32 patients which had been subjected to ACDF using the Scarlet AC-T (*) secured titanium cage. The studied population comprised 13 males (40.6%) and 19 females (59.4%), aged between 36 and 76 years, (mean 56.5 y) and operated between October 1st 2014 and June 1st 2016. A total of 39 cages were implanted (25 in one-level surgery and 14 in two-levels). The most frequently operated levels were C5C6 (22), C6C7 (13), C4C5 (2) and C3C4 (2). 

All the operated patients initially presented with neck and arm pain. 17 had signs of myelopathy. The predominant diagnosed etiologies were: soft disc herniation (9 patients), disco-osteophytic compression (22) and pseudarthrosis (1).

The patients were evaluated for immediate post-operative complications. After 6 months, screw loosening, device subsidence/migration and fusion were assessed by ROM measurement on dynamic lateral Xrays. 

We observed 2 cases of minimal subsidence, 2 mild transient dysphagias, 1 superficial infection, no screw loosening, and no migration. Bridging bone around the cage was observed in 27 levels (69.2 %). 30 levels (77,0 %) showed signs of solid fusion, 7 leve1s (4.9 %) signs of incomplete or ongoing fusion, and 2 levels (5.1 %) radiological signs of failed fusion.

ACDF with the Scarlet AC-T cervical secured cage is safe. No implant failure or implant related complication could be observed. Solid or ongoing fusion was observed in 94,9 % of the operated levels after 6 months.