Abstract:

BACKGROUND: Smith-Robinson technique combined with metallic fixation is widely used for the treatment of prolapse of single-level cervical intervertebral disc, but it is controversial to resect the posterior longitudinal ligament (PLL).
OBJECTIVE: To observe the effects of resection of PLL by Smith-Robinson technique combined with metallic fixation for treating prolapse of single-level cervical intervertebral disc.
METHODS: A total of 45 patients who underwent the PLL resection by the Smith-Robinson technique combined with bone grafting with peek Cage and titanium plate internal fixation for treating prolapse of single-level cervical intervertebral disc at the Department of Orthopedics, General Hospital of Tianjin Medical University between 2005 and 2008 were retrospectively analyzed.
RESULTS AND CONLUSION: All patients received a 12-36 months follow-up. Compared with preoperation, the mean JOA score was significantly increased (P < 0.05) and the visual analogue scale score was significantly decreased at a 12 months follow-up (P < 0.05). The segmental Cobb angle and disc height were significantly improved postoperatively (P < 0.05). At the last follow up a solid fusion was achieved in 100% and no graft displacement was noted. Excellent clinical results of 30 cases, good in 13 cases, 2 cases in fair, and poor in 0 case, the fine rate was 95.6%. It suggested that PLL resection by Smith-Robinson technique not only achieved the maximum pressure to the spinal cord and nerve root but also prevented the subsidence of the graft and angulation of the fused segment effect.