CERVICAL STABILIZATION BY PLATE AND BONE FUSION
CERVICAL STABILIZATION BY PLATE AND BONE FUSION
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DOI：
10.1097/00007632-198803000-00003
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发表时间：
1988-03-01
期刊：
影响因子：
3
通讯作者：
JACKSON, WT
中科院分区：
文献类型：
--
作者：
BROWN, JA;HAVEL, P;JACKSON, WT
对10例脊椎型颈椎病患者和3例神经根型颈椎病或创伤患者在神经减压后进行前路钢板和骨融合联合稳定。在1至4个节段进行内侧椎体次全切除术。髂骨嵴或腓骨移植物通过固定在移植物和相邻椎体上的钢板固定。所有患者术后均置入Minerva支具。所有病例均成功融合，无移植物移位或脊柱后凸。实现了早期康复。严重颈椎病患者发生死亡。这包括2/13例手术中需要重新插管的呼吸抑制、螺钉松动或硬件和移植物突出导致的吞咽困难（2/13）以及螺钉松动（2/13）。85%（11/13）的患者出现神经功能改善。所有病例均未出现神经功能恶化。我们从早期随访中得出结论，前路骨融合和补充钢板为不稳定的颈椎提供了有效的稳定。需要多节段内侧椎体次全切除和融合术的严重颈椎病和痉挛性四肢轻瘫患者存在更大的发病风险。
Anterior stabilization with combined plate and bone fusion was performed after neural decompression on ten patients for spondylotlc cervical myelopathy, and for radiculopathy or trauma In three patients. Medial corpectomy was performed at one to four levels. Iliac crest or flbular bone grafts were secured by plates anchored to the graft and adjacent vertebral bodies. All patients were placed In Minerva braces postoperatively. There was successful fusion In all cases, and no graft dislodgement or kyphosis. Early Initiation of rehabilitation was achieved. Morbidity occurred In patients with severe spondylotic cervical myelopathy. This Included respiratory depression requiring relntubatlon In 2/13 procedures, dysphagia (2/13) from loosening of the screws or prominent hardware and graft, and screw loosening (2/13). Neurological Improvement was present In 85%(11/13) of patients. There was no deterioration of neurological function in any case. We conclude from this early follow-up that anterior bone fusion with supplemental plates provides effective stabilization for the unstable cervical spine. Greater morbidity risk exists in patients with severe spondylotic cervical myelopathy and spastic quadriparesis who required multilevel medial corpectomies and fusion.