Cervical Cage Introduction, Sizes, Uses and Advantages.

Cervical Cage

Cervical Cage Introduction

Cervical spine problems that cause discomfort, nerve compression, and instability can be crippling. Thankfully, improvements in spine surgery have given rise to efficient treatment methods that can reduce these symptoms and reestablish spinal stability. One such development is the cervical cage, an medical implant created to encourage fusion and speed up the healing process.

A cervical cage, often referred to as an intervertebral cage or a cervical interbody cage, is used in spinal surgery to treat several diseases that affect the cervical spine (the area of the neck). It is intended especially for cervical interbody fusion surgeries. Its primary objective is to restore the height and alignment of the affected vertebrae, promote bone growth, and stabilize the cervical spine.

Cervical Cage Sizes

Cervical cages are built of biocompatible materials such as titanium or polyetheretherketone (PEEK). These materials have outstanding biomechanical qualities, allowing for long-term stability and integration with the surrounding bone. The cages come in a variety of sizes and shapes to meet diverse patient anatomy and surgical needs. To promote bone growth and fusion, the cage’s surface may be porous or rough.

Cervical Cage are available in various sizes such as.
Diameters: 4mm, 5mm, 6mm, 7mm, 8mm, 9 mm and 10 mm
Length: 13mm
Width: 16mm

Cervical Cage Uses

Cervical cages are used to treat a variety of cervical spine disorders, such as degenerative disc disease, herniated discs, spinal stenosis, and instability. These problems frequently cause discomfort, restricted mobility, and nerve compression, needing surgical intervention to alleviate symptoms and restore spine functionality.

The cervical spine is made up of many vertebrae that are connected by intervertebral discs. These discs operate as cushions in the neck, allowing for movement and flexibility. Degenerative disc disease, ruptured discs, spinal stenosis, or instability, on the other hand, might cause discomfort, nerve compression, or spinal instability. A cervical fusion surgery may be required in such circumstances.

Cervical Cage Advantage

Cervical cages provide various advantages in spinal surgery. For starters, they provide instant structural support and stability to the spine, relieving pain and avoiding further degeneration. Second, the cages promote bone development and fusion between adjacent vertebrae, which aids in the healing process. Furthermore, the use of cervical cages eliminates the necessity for traditional bone graft harvesting, decreasing donor site morbidity and associated problems.

Cervical Cage Surgical Techniques

During cervical fusion surgery, the injured disc or a section of it is removed to decompress the nerves, and the empty disc space is replaced with a cervical cage. The cage functions as a spacer, restoring the height and normal alignment of the afflicted vertebrae. It provides support, allows for fusion, and encourages the formation of new bone between the adjacent vertebrae.

After removing the injured disc, the surgeon usually inserts the cervical cage into the disc space. To facilitate fusion, the cage may be filled with bone graft material, such as autograft (bone obtained from the patient’s own body) or allograft (cadaveric or synthetic bone substitute). The surrounding bone grows into and around the cage over time, forming a strong fusion mass and stabilising the spine.

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Cervical Cage Contraindications

Contraindications may be qualified or total, and need to be taken into consideration when evaluating the prognosis in each case. The physician’s education, training and professional judgement must be relied upon to choose the most appropriate device and treatment. Conditions presenting an increased risk of failure include:

  • Any active or suspected latent infection or marked local inflammation in or about the affected area.
  • Compromised vascularity that would inhibit adequate blood supply to the fracture or the operative site.
  • Bone stock compromised by disease, infection or prior implantation that can not provide adequate support and/or fixation of the devices.
  • Material sensitivity, documented or suspected.
  • Obesity. An overweight or obese patient can produce loads on the implant that can lead to failure of the fixation of the device or to
    failure of the device itself.
  • Patients having inadequate tissue coverage over the operative site.
  • Implant utilization that would interfere with anatomical structures or physiological performance.
  • Any mental or neuromuscular disorder which would create an unacceptable risk of fixation failure or complications in postoperative care.
  • Other medical or surgical conditions which would preclude the potential benefit of surgery.
  • All associated diseases which could endanger the function and success of the Cervical Cage .

Warnings and Precautionary for Cervical Cage

Before using Cervical Cage, the surgeon and ancillary staff should study the safety information in these instructions, as well as any product-specific information in the product description, surgical procedures and/or brochures.

Cage is made from medical grade materials and are designed, constructed and produced with utmost care. These quality Cage assure best working results provided they are used in the proper manner. Therefore, the following instructions for use and safety recommendations must be observed.

Improper use of  Cage can lead to damage to the tissue, premature wear, destruction of the instruments and injury to the operator, patients or other persons.

It is vital for the operating surgeon to take an active role in the medical management of their patients. The surgeon should thoroughly understand all aspects of the surgical procedure and instruments including their limitations. Care in appropriate selection and proper use of surgical instruments is the responsibility of the surgeon and the surgical team. Adequate surgical training should be completed before use of implants.

Factors which could impair the success of the operation:

  • Allergies to implanted materials.
  • Localized bone tumours.
  • Osteoporosis or osteomalacia.
  • System disease and metabolic disturbances.
  • Alcohol and drug abuse.
  • Physical activities involving excessive shocks, whereby the implant is exposed to blows and/or excessive loading.
  • Patients who are mentally unable to understand and comply with the doctor’s instructions.
  • Poor general health.

Possible Adverse Effects

The following adverse effects are the most common resulting from implantation:

  • Loosening of the Cage, which may result from cyclic loading of the fixation site and/or tissue reaction of the implant.
  • Early and late infection.
  • Further bone fracture resulting from unusual stress or weakened bone substance.
  • Temporary or chronic neural damage resulting from pressure or hematomata.
  • Wound hematomas and delayed wound healing.
  • Vascular disease including venal thrombosis, pulmonary embolism and cardiac arrest.
  • Heterotopic ossification.
  • Pain and discomfort due to presence of the Cervical Cage.
  • Mechanical failure of the implant, including bending, loosening or breakage.
  • Migration of implant resulting in injury.

Preoperative Planning for Cervical Cage

The operating planning is carried out following a thorough clinical evaluation of the patient, Also, x-rays must be taken to allow a clear indication of the bony anatomy and associated deformities. At the time of the operation, the corresponding implantation instruments in addition to a complete size of Cervical Cage must be available.

The clinician should discuss with the patient the possible risks and complications associated with the use of implants. It is important to determine pre-operatively whether the patient is allergic to any of the implant materials. Also, the patient needs to be informed that the performance of the device cannot be guaranteed as complications can affect the life expectancy of the device.

Cervical Cage Precautions

  • Confirm functionality of instruments and check for wear during reprocessing. Replace worn or damaged instruments prior to use.
  • It is recommended to use the instruments identified for this Cage.
  • Handle devices with care and dispose worn bone cutting instruments in a sharps container.
  • Always irrigate and apply suction for removal of debris potentially generated during implantation or removal.

Cervical Cage Warnings

  • Cervical Cage can break during use (when subjected to excessive forces). While the surgeon must make the final decision on removal of the broken part based on associated risk in doing so, we recommend that whenever possible and practical for the individual patient, the broken part should be removed. Be aware that implants are not as strong as native bone. Implants subjected to substantial loads may fail.
  • Instruments, screws and cut plates may have sharp edges or moving joints that may pinch or tear user’s glove or skin.
  • Take care to remove all fragments that are not fixated during the surgery.
  • While the surgeon must make the final decision on implant removal, we recommend that whenever possible and practical for the individual patient, fixation devices should be removed once their service as an aid to healing is accomplished. Cage removal should be followed by adequate post-operative management to avoid refracture.

Cervical Cage General Adverse Events

As with all major surgical procedures, risks, side effects and adverse events can occur. While many possible reactions may occur, some of the most common include: Problems resulting from anesthesia and patient positioning (e.g. nausea, vomiting, dental injuries, neurological impairments, etc.), thrombosis, embolism, infection, nerve and/or tooth root damage or injury of other critical structures including blood vessels, excessive bleeding, damage to soft tissues incl. swelling, abnormal scar formation, functional impairment of the musculoskeletal system, pain, discomfort or abnormal sensation due to the presence of the device, allergy or hypersensitivity reactions, side effects associated with hardware prominence, loosening, bending, or breakage of the device, mal-union, non-union or delayed union which may lead to breakage of the Cervical Cage, reoperation.