Degenerative conditions of the spine represent a group of most common lifestyle associated diseases with significant medical and important social impact. Clinical symptoms and syndromes of surgically considerable degenerative diseases of the spine mostly result from nerve root or spinal cord compression caused by a herniated intervertebral disc or a dorsal osteophyte. Therefore, the main goal of the surgical treatment is decompression of the neural structures by complete removal of the intervertebral disc and the osteophytes followed by insertion of an artificial disc spacer into the remaining space. The most frequently used procedure for treating such findings is called anterior cervical discectomy. Since its first introduction in 1950, several modifications of the original technique have been introduced. Their common feature is that removal of the degenerated intervertebral disc or the osteophytes requires stabilization of the adjacent segments by fusion. Thus, implantation of an interbody spacer results not only in intervertebral space reconstruction, but by immobilizing the adjacent vertebral bodies also in forming a firm bony bridging between them--and ultimately a solid bony block. Our paper provides a review of cervical interbody spacers in the order of their evolution from auto- and allografts, through compact materials, cages and dynamic artificial disks. Furthermore, different types of cage filling materials used for fusion augmentation are also discussed.
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J Int Med Res
January 2025
Department of Orthopaedics, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine; Key Laboratory of Musculoskeletal System Degeneration and Regeneration Translational Research of Zhejiang Province, Hangzhou, China.
An 18-year-old female patient presented with a 1-month history of low back pain, which had worsened and was accompanied by radiating pain in the right lower limb for half a month. She was admitted to our hospital with computed tomography and magnetic resonance imaging findings suggesting calcification of the L3/4 disc and a large intraspinal mass at the L2-4 level. The patient's symptoms did not improve with conservative treatment, and her muscle strength rapidly declined.
View Article and Find Full Text PDFJOR Spine
March 2025
SERGAS (Servizo Galego de Saude) and IDIS (Instituto de Investigación Sanitaria de Santiago), The NEIRID Group (Neuroendocrine Interactions in Rheumatology and Inflammatory Diseases) Santiago University Clinical Hospital Santiago de Compostela Spain.
Background: Intervertebral disc degeneration (IVDD) is one of the main causes of chronic low back pain. The degenerative process is often initiated by an imbalance between catabolic and anabolic pathways. Despite the large socio-economic impact, the initiation and progress of disc degeneration are poorly understood.
View Article and Find Full Text PDFAdv Healthc Mater
January 2025
Department of Orthopedic Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, China.
Characterized by a cascade of profound changes in nucleus pulposus (NP) cells, extracellular matrix (ECM), and biomechanics, intervertebral disc degeneration is a common multifactorial condition that may lead to various degenerative lumbar disorders. Therapeutic strategies targeting a single factor have shown limited efficacy in treating disc degeneration, and approaches that address multiple pathological ingredients are barely reported. In this study, engineered cell membrane-encapsulated keratin nanoparticles are developed to simultaneously alleviate NP cell senescence and promote ECM remodeling.
View Article and Find Full Text PDFStudy Design: A retrospective chart review was conducted at a single institution.
Objective: The purpose of this study was to investigate the clinical outcomes of cervical disc arthroplasty (CDA) used for the treatment of symptomatic adjacent segment disease (ASD) developed after anterior cervical discectomy and fusion (ACDF).
Background: A major clinical concern following ACDF is the development of ASD.
Acta Orthop Traumatol Turc
December 2024
Department of Orthopedics and Traumatology, Brugmann University Hospital Center, Free University of Brussels, Brussels, Belgium.
Objective: The aim of this study was to evaluate disc metabolism after decreasing the axial load through surgery by assessing the glycosaminoglycan content through a non-invasive method-delayed gadolinium-enhanced magnetic resonance imaging of cartilage (dGEMRIC).
Methods: Sixteen patients with mono-segmental disc degeneration (L4-L5 or L5-S1) who underwent posterior lumbar spine fixation with intervertebral distraction of 2 consecutive vertebrae using monoaxial transpedicular screws and lyophilized allograft to achieve segmental fusion, and who had a follow-up period of at least 2 years, were included in this study. The first lumbar disc was used as the control group.
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