Minimally Disruptive Posterior Cervical Fusion with DTRAX Cervical Cage for Single Level Radiculopathy - Results in 10 Patients at 1-Year

Objective: The authors present one-year clinical and radiographic outcomes of 10 patients with single level cervical radiculopathy due to spondylosis and stenosis treated with a minimally disruptive instrumented fusion procedure employing bilateral posterior cervical cages. Methods: A retrospective study of 10 patients with one-year follow-up who underwent cervical fusion using bilateral posterior cervical cages placed between the facet joints was conducted at a single center. Neck Disability Index (NDI), Visual Analog Scale (VAS) for neck and arm pain, neurological status, adverse events, x-rays and computed tomography (CT) were collected at baseline and 6-weeks, 3-, 6and 12-months postoperatively. X-ray and CT were assessed for segmental and overall cervical lordosis, fusion, and device retention. Results: Subject age range was 51 to 78 years with a mean of 68 (6 male, 4 female). Five patients were treated at C5-6, four at C6-7, and one at C4-5. NDI and VAS scores significantly improved immediately after surgery; outcomes were sustained at one year. NDI scores improved from a mean of 35 at baseline to 15 at one year. Mean scores on VAS for neck pain improved from a baseline of 8 to 2.5 at one year. Results were similar for arm pain on VAS; scores improved from 7.5 to 1.5 preand post-op, respectively. Evidence of fusion was observed for all subjects on lateral flexion/extension plain film radiographs. Bridging bone on CT was present in 9 subjects; findings were indeterminate for one subject. No significant change in segmental or overall lordosis was observed. There were no device breakages, device back out, or surgical re-interventions at one year. Conclusions: One-year results show favorable improvements in pain and function in subjects with single level cervical radiculopathy due to spondylosis and foraminal stenosis treated with minimally disruptive posterior cervical fusion using bilateral cervical cages.