Methods of fixation and interbody fusion in cervical discectomy: a literature review

Rationale: According to world data, radicular syndrome causing neurological disorders is 83.2 cases per 100,000 population per year, with a subsequent increase in prevalence after 40 years of age. If conservative treatment of cervical disc herniations is ineffective, surgical treatment is required. The gold standard of surgical treatment is an anterior cervical discectomy with fixation (ACDF). However, there is no consensus on the choice of the optimal material for fixation in the modern medical community.Purpose: To review the literature sources devoted to interbody fixation of the cervical segment during discectomy, to improve the results of these operations.Materials and Methods: We used PubMed (http://www.ncbi.nlm.nih.gov/pubmed), Elibrary (http://elibrary.ru), and the archives of the journals “Neurosurgery” and “Spine Surgery” to search for relevant publications.Results: The data of the world literature on methods and materials for fixation of the cervical spine during discectomy were analyzed. We reviewed the methods of cervical segment stabilization with autograft from the iliac crest, segment fixation with a plate, interbody cages made of titanium and PEEK with and without filling with osteoconductive materials, and considered early models of biodegradable cages made of lactide polymer. According to the data obtained, the choice of material and method for fixation of the cervical segment remains an open question. The most frequent complications are related to graft migration and subsidence.Conclusion: Taking into account the obtained data and the urgency of the problem in the Russian Research Center of Surgery named after academician B.V. Petrovsky together with the Kurchatov Institute are developing a biocompatible biodegradable device/cage for cervical spine stabilization during cervical spine surgeries. At present, medical and technical requirements for the polymer device have been formed, and a search for suitable materials is underway