Surgical Results of Anterior Fusion Using Cage Filled with Novabone Mixed with Autologous Bone Graft in Cervical Disc Disease

Cervical interbody cages have been developed to provide anterior structural support. Limited numbers of investigations have focused on results of anterior cervical fusion, using cage implants considering the material used for filling the cage. The objective of this study is to report the surgical results of anterior cervical fusion using interbody cages filled with Novabone and autologous bone graft and, moreover, to compare these results with other series applied autologous graft, solely, as the filler material. Demographic and clinical characteristics of 33 cases with cervical degenerative disc disease, who underwent fusion using interbody cages filled with Novabone and autologous bone graft in Mehrad Hospital from 2003 to 2006 were evaluated and the outcome was determined by assessing the improvement of postoperative axial and radicular pain and fusion success by radiographic assessment including sagittal alignment and kyphosis and the results were compared with other series applied autologous graft as the cage filling material. In follow up visits, complications related to cage implants were reported, as well. Thirty three patients with cervical degenerative disc disease underwent fusion procedure with interbody cages filled with Novabone mixed with autologous bone graft in Mehrad Hospital between 2003 and 2006. Nineteen cases were male (57.6%) and fourteen ones (42.4%) were female. The mean age at the time of diagnosis was 47.1 y. One-level fusion was performed in 23 cases, 10 patients underwent two-level fusion, and in one patient three-level fusion was performed. The mean follow-up period was 13 months. After one year, successful fusion occurred in 91.3% of cases with one level fusion and 80% in cases with multiple level fusions. According to this study, the early-phase fusion success rate of Novabone-filled cervical cages mixed with autologous bone graft, are inferior to the results obtained from cages filled with pure autologous bone. Neveretheless, after one year, the results in both groups are same. Therefore, it is advocated to use the bone fragments obtained from resection of osteophytes, as the filler material mixed with synthetic bone grafts not only to achieve more appropriate fusion, but also to obviate harvesting bone from iliac crest.