Letter to the Editor: A Randomized Control Trial Comparing Local Autografts and Allografts in Single Level Anterior Cervical Discectomy and Fusion Using a Stand-Alone Cage

Article information

Asian Spine J. 2022;16(2):311-312

Publication date (electronic) : 2022 April 25

doi : https://doi.org/10.31616/asj.2022.0100.r1

¹Trauma and Emergency (Orthopaedics), All India Institute of Medical Sciences, Raipur, India

²Postgraduate Institute of Medical Education and Research, Chandigarh, India

Corresponding author: Sanjay Singh Rawat Trauma and Emergency (Orthopaedics), Gate No. 1, Great Eastern Road, Opposite Gurudwara, All India Institute of Medical Sciences Campus, Tatibandh, Raipur, Chhattisgarh 492099, India Tel: +91-9927444089, Fax: +91-1722756740, E-mail: sanjaymamc07@gmail.com

Received 2022 March 7; Accepted 2022 March 11.

Dear Editor,

We read this article “A randomized control trial comparing local autografts and allografts in single level anterior cervical discectomy and fusion using a stand-alone cage” by Kanna et al. [1] with interest and had a deliberate discussion at length extensive amongst our peer of spine surgeons. At the outset, we congratulate the authors for a thought-provoking article on a less pondered topic of a common problem and request generous views of our few salient queries.

1. A single-center study inclusive of only 27 patients operated by a single surgeon may be a too-small sample size to conclude on a procedural option for a common cervical spine problem being seen and tackled by spine surgeons [2,3].
2. In the study, 21 patients were diagnosed with radiculopathy and six with myelopathy. In these sub-cohorts, how many underwent local grafting and allograft subsequently and had the two diagnoses potentially skew and bias the study result?
3. The randomization numbers were generated by a computer-generated random chart in this study; how was it ensured that patients falling in the local grafting group would have sufficient osteophytes to fill in the standalone cage being used on them [4]?
4. Is there any specific reason for patients with the American Society of Anesthesiologists grading >3 being excluded from the study?

Notes

No potential conflict of interest relevant to this article was reported.

References

1. Kanna RM, Perambuduri AS, Shetty AP, Rajasekaran S. A randomized control trial comparing local autografts and allografts in single level anterior cervical discectomy and fusion using a stand-alone cage. Asian Spine J 2021;15:817–24.

2. Miller LE, Block JE. Safety and effectiveness of bone allografts in anterior cervical discectomy and fusion surgery. Spine (Phila Pa 1976) 2011;36:2045–50.

3. Floyd T, Ohnmeiss D. A meta-analysis of autograft versus allograft in anterior cervical fusion. Eur Spine J 2000;9:398–403.

4. Park JI, Cho DC, Kim KT, Sung JK. Anterior cervical discectomy and fusion using a stand-alone polyetheretherketone cage packed with local autobone : assessment of bone fusion and subsidence. J Korean Neurosurg Soc 2013;54:189–93.

Article information Continued

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.