Journal of Korean Neurosurgical Society

The Korean Neurosurgical Society (대한신경외과학회)
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The Impact of Menopause on Bone Fusion after the Single-Level Anterior Cervical Discectomy and Fusion

  • Park, Sung Bae (Department of Neurosurgery, Seoul National University Boramae Medical Center) ;
  • Chung, Chun Kee (Department of Neurosurgery, Seoul National University College of Medicine) ;
  • Lee, Sang Hyung (Department of Neurosurgery, Seoul National University Boramae Medical Center) ;
  • Yang, Hee-Jin (Department of Neurosurgery, Seoul National University Boramae Medical Center) ;
  • Son, Young-Je (Department of Neurosurgery, Seoul National University Boramae Medical Center) ;
  • Chung, Young Seob (Department of Neurosurgery, Seoul National University Boramae Medical Center)
  • Received : 2013.07.10
  • Accepted : 2013.12.12
  • Published : 2013.12.28
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Abstract

Objective : To evaluate the successful fusion rate in postmenopausal women with single-level anterior cervical discectomy and successful fusion (ACDF) and identify the significant factors related to bone successful fusion in pre- and postmenopausal women. Methods : From July 2004 to December 2010, 108 consecutive patients who underwent single-level ACDF were prospectively selected as candidates. Among these, the charts and radiological data of 39 women were reviewed retrospectively. These 39 women were divided into two groups : a premenopausal group (n=11) and a postmenopausal group (n=28). To evaluate the significant factors affecting the successful fusion rate, the following were analyzed : the presence of successful fusion, successful fusion type, age, operated level, bone mineral density, graft materials, stand-alone cage or plating with autologous iliac bone, subsidence, adjacent segment degeneration, smoking, diabetes mellitus, and renal disease. Results : The successful fusion rates of the pre- and postmenopausal groups were 90.9% and 89.2%, respectively. There was no significant difference in the successful fusion rate or successful fusion type between the two groups. In the postmenopausal group, three patients (10.8%) had successful fusion failure. In the postmenopausal group, age and subsidence significantly affected the successful fusion rate (p=0.016 and 0.011, respectively), and the incidence of subsidence in patients with a cage was higher than that in patients with a plate (p=0.030). Conclusion : Menopausal status did not significantly affect bone successful fusion in patients with single-level ACDF. However, in older women with single-level ACDF, the combination of use of a cage and subsidence may unfavorably affect successful fusion.

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References

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