Soft Tissue Swelling Incidence Using Demineralized Bone Matrix in the Outpatient Setting

Soft tissue swelling incidence using demineralized bone matrix in the outpatient setting.

Scientific Paper

Chin KR1Pencle FJR2Seale JA3Valdivia JM3.

Interested medical professionals can read through the full paper, published in the Journal of the AAOS, here.

Aim

To assess use of demineralized bone matrix (DBM) use in anterior cervical discectomy and fusion (ACDF) in outpatient setting.

Methods

One hundred and forty-five patients with prospectively collected data undergoing single and two level ACDF with DBM packed within and anterior to polyetheretherketone (PEEK) cages. Two groups created, Group 1 (75) outpatients and control Group 2 (70) hospital patients. Prevertebral soft tissue swelling (PVSTS) was measured anterior to C2 and C6 on plain lateral cervical radiographs preoperatively and one week postoperatively and fusion assessed at two years.

Results

There was no intergroup significance between preoperative and postoperative visual analogue scales (VAS) and neck disability index (NDI) scores between Group 1 and 2. Mean preoperative PVSTS in Group 1 was 4.7 ± 0.2 mm at C2 level and 11.1 ± 0.5 at C6 level compared to Group 2 mean PVSTS of 4.5 ± 0.5 mm and 12.8 ± 0.5, P = 0.172 and 0.127 respectively. There was no radiographic or clinical evidence of adverse reaction noted. In Group 1 mean postoperative PVSTS was 5.5 ± 0.4 mm at C2 and 14.9 ± 0.6 mm at C6 compared Group 2 mean PVSTS was 4.9 ± 0.3 mm at C2 and 14.8 ± 0.5 mm at C6, P = 0.212 and 0.946 respectively. No significant increase in prevertebral soft tissue space at C2 and C6 level demonstrated.

Soft tissue swelling incidence using demineralized bone matrix in the outpatient setting.
Preoperative radiograph showing retropharyngeal/prevertebral soft tissue at the level of C2 vertebral body and at the level of C6 vertebral body.
Soft tissue swelling incidence using demineralized bone matrix in the outpatient setting.
Photograph showing demineralized bone matrix packed within cage after insertion into disc space and anterior cervical discectomy and fusion plate.
Soft tissue swelling incidence using demineralized bone matrix in the outpatient setting.
Plain lateral radiograph of the cervical spine, taken one week postoperatively, which shows the normal dimensions of the prevertebral space being less than 50% of the vertebral body at C2 and less than the body width of C6 respectively.

Conclusion 

ACDF with adjunct DBM packed PEEK cages showed a statistical significant intragroup improvement in VAS neck pain scores and NDI scores (P = 0.001). There were no reported serious patient complications; post-operative radiographs demonstrated no significant difference in prevertebral space. We conclude that ACDF with DBM-packed PEEK cages can be safely done in an ASC with satisfactory outcomes.

About Author Dr. Kingsley R. Chin

Misaligned Versus Straight Placement of Anterior Cervical Plates: A Clinical and Radiologic Outcomes Study, JAAOS, Dr. Kingsley R. Chin
Dr. Kingsley R. Chin, founder of philosophy and practice of The LES Society and The LESS Institute

Dr. Kingsley R. Chin is a board-certified Harvard-trained orthopedic spine surgeon and professor with copious business and information technology experience. He sees a niche opportunity where medicine, business and information technology meet and is uniquely experienced at the intersection of these three professions. He currently serves as Professor of Clinical and Biomedical Sciences at the Charles E. Schmidt School of Medicine at Florida Atlantic University and Professor of Clinical Orthopaedic Surgery at the Herbert Wertheim College of Medicine at Florida International University and has experience as Assistant Professor of Orthopaedics at the University of Pennsylvania Medical School and Visiting Professor at the University of the West Indies.

Learn more about Dr. Chin here and connect via LinkedIn.

About Less Exposure Surgery

Less Exposure Surgery (LES) is based on a new philosophy of performing surgery, leading the charge to prove through bench and clinical outcomes research that LES treatment options are the best solutions – to lowering the cost of healthcare, improving outcomes and increasing patient satisfaction. Learn more at LESSociety.org.

The LES Society philosophy: “Tailor treatment to the individual aiding in the quickest recovery and return to a pain-free lifestyle, using LES® techniques that lessen exposure, preserve unoffending anatomy and utilize new technologies which are safe, easy to adopt and reproducible. These LES®techniques lessen blood loss, surgical time and exposure to radiation and can be safely performed in an outpatient center. Less is more.” – Kingsley R. Chin, MD

About The LESS Institute

The LESS Institute is the world leader center of excellence in Less Exposure Surgery. Our safe, effective outpatient treatments help patients recover quickly, avoid expensive hospital stays and return home to their family the same day. Watch our patient stories, follow us on Facebook and visit TheLESSInstitute.com to learn more.

About SpineFrontier

The above study utilized LES Technology from SpineFrontier – leading provider of LES Technologies and instruments – offering surgeons and patients superior technology and services.

Scientific Paper Author and Citation Details

Authors

Chin KR1Pencle FJR2Seale JA3Valdivia JM3.

Author information

  • Charles E. Schmidt College of Medicine at Florida Atlantic University, Boca Raton, FL 33431, United States.
  • Less Exposure Surgery Society, Malden, MA 02148, United States. fabiopencle@thelessinstitute.com.
  • Less Exposure Surgery Specialists Institute, Fort Lauderdale, FL 33311, United States.

Leave a Reply

Your email address will not be published. Required fields are marked *