Long term outcome and adjacent disc degeneration after anterior cervical discectomy and fusion with titanium cylindrical cages
Long term outcome and adjacent disc degeneration after anterior cervical discectomy and fusion with titanium cylindrical cages
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DOI：
10.1007/s00701-009-0217-5
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发表时间：
2009-04-01
影响因子：
2.4
通讯作者：
Mizoi, Kazuo
中科院分区：
文献类型：
--
作者：
Sugawara, Taku;Itoh, Yasunobu;Mizoi, Kazuo
颈椎前路髓核摘除融合术(ACDF)被广泛应用于颈椎退行性疾病的治疗。自体或同种异体骨移植用于椎间融合，可获得满意的长期疗效。然而，自体移植物的获取会导致供区并发症，而同种异体移植物的融合率较低。螺纹式钛保持架(TC)最近被引入以克服这些缺点，但几乎没有长期效果的证据。41例患者进行了至少5年(5-8.3年)的临床和影像随访。提出了一种新的计算机辅助X线测量方法，ACDF与TC的融合优良率达80%，融合率达95%，并发症少。通过我们的测量方法，在50%的患者中发现了无症状的邻近椎间盘退变。然而，5%的患者发生了有症状的邻近椎间盘退变，只有2%的患者需要再次手术。这些结果与ACDF加自体或同种异体植骨的结果相当或更好。ACDF加TC固定可达到较好的固定效果，远期疗效良好。
Anterior cervical discectomy and fusion (ACDF) is widely performed for the treatment of cervical spinal degenerative disease. Autogenic or allogenic bone grafts are used for interbody fusion with satisfactory long term outcomes. However, harvest of the autograft causes donor site complications and allograft is associated with low fusion rate. Threaded titanium cages (TC) have recently been introduced to cope with these disadvantages, but there is little evidence of long term results.The long term outcome was studied after ACDF using TC. Clinical and imaging follow up was performed in 41 patients for at least 5 years (range 5-8.3 years). New computer-assisted measurement methods for radiographs are proposed.ACDF with TC achieved 80% excellent or good outcome by Odom's criteria, 95% fusion rate, and few minor complications. Asymptomatic adjacent disc degeneration was detected in 50% of the patients by our measurement methods. However, symptomatic adjacent disc degeneration occurred in 5% of the patients and only 2% required additional surgery.These results are comparable or better than those after ACDF with autograft or allograft. ACDF with TC can achieve rigid fixation and provide good long term results.