Chinese Journal of Tissue Engineering Research ›› 2014, Vol. 18 ›› Issue (21): 3293-3298.doi: 10.3969/j.issn.2095-4344.2014.21.003
Previous Articles Next Articles
Li Hong, Li Chun-de, Yi Xiao-dong, Liu Hong
Online:
2014-05-21
Published:
2014-05-21
Contact:
Li Chun-de, Chief physician, Doctoral supervisor, Department of Orthopedics, Peking University First Hospital, Beijing 100034, China
About author:
Li Hong, M.D., Associate chief physician, Department of Orthopedics, Peking University First Hospital, Beijing 100034, China
CLC Number:
Li Hong, Li Chun-de, Yi Xiao-dong, Liu Hong. Anterior cervical discectomy and fusion by cervical cage with bioactive glass[J]. Chinese Journal of Tissue Engineering Research, 2014, 18(21): 3293-3298.
2.5 典型病例 病例1:34岁男性患者,行走不稳伴左上肢疼痛7个月。术前颈椎正侧位提示颈椎反弓,C5/6间隙狭窄(图1A);颈椎MRI提示C5/6间盘突出明显,压迫硬膜囊(图1B)。术前JOA评分8分。择期行颈椎前路间盘切除、椎间融合,采用Styker Solis颈椎融合器联合生物活性玻璃行椎间融合,植骨量 5 mL,手术时间55 min,出血量15 mL,术后恢复顺利无并发症出现。术后第2天佩戴颈托下地活动,残留肩部轻微疼痛,末次随访JOA评分16分。术后颈椎正侧位提示椎间融合器位置良好,颈椎曲度恢复(图1C)。术后3个月复查颈椎正侧位提示颈椎曲线维持良好,椎间隙椎间融合器内已有连续骨小梁长入,融合良好(图1D),颈椎动力位提示融合节段无相对运动(图1E),MRI提示减压良好,脊髓已无压迫(图1F)。"
病例2:44岁女性患者,行走不稳伴双上肢疼痛6个月,加重2周。术前颈椎正侧位提示颈椎反弓,C5/6间隙狭窄(图2A);颈椎MRI提示C5/6间盘突出明显,压迫硬膜囊(图2B)。术前JOA评分9分。择期行颈椎前路间盘切除、椎间融合术,采用Styker Solis颈椎融合器联合自体髂骨松质骨,植骨量为5 mL,手术时间75 min,出血量55 mL,术后恢复顺利无并发症出现。术后第2天佩戴颈托下地活动,残留肩部轻微疼痛,末次随访JOA评分15分。术后颈椎正侧位提示椎间融合器位置良好,颈椎曲度恢复(图2C)。术后3个月复查颈椎正侧位提示椎体前缘已有连续骨桥形成,椎间融合器内见骨组织长入(图2D),CT提示椎间融合器内大量新生骨长入并已骨性融合(图2E,F),MRI提示减压良好,脊髓已无压迫(图2G)。 2.6 不良反应 两组病例均未出现感染、伤口渗出、排异反应的病例。两组病例术后均未出现伤口感染、延迟愈合等并发症。对照组中治疗后6个月时有2例持续性取骨区疼痛,给予口服镇痛药物得以缓解。"
[1]Emery SE,Bohlman HH,Bolesta MJ,et al.Anterior cervical decompression and arthrodesis for the treatment of cervical spondylotic myelopathy:Two to seventeen-year follow-up.J Bone Joint Surg Am.1998;80(7):941-951. [2]Lin CN,Wu YC,Wang NP,et al.Preliminary experience with anterior interbody titanium cage fusion for treatment of cervical disc disease.Kaohsiung J Med Sci. 2003;19(5): 208-216. [3]Smith GW,Robinson RA.The treatment of certain cervical-spine disorders by anterior removal of the intervertebral disc and interbody fusion.J Bone Joint Surg Am.1958;40-A(3):607-624. [4]Cloward RB.The anterior approach for removal of ruptured cervical disks. J Neurosurg.1958;15(6):602-617. [5]Suetsuna F,Yokoyam T,Kenuka E,et al.Anterior cervical fusion using porous hydroxyapatite ceramics for cervical disc herniation.A two-year follow-up. Spine J. 2001;1:348-357. [6]McDuffee LA,Anderson GI.In vitro comparison of equine cancellous bone graft donor sites and tibial periosteum as sources of viable osteoprogenitors.Vet Surg. 2003;32: 455-463. [7]Thalgott JS,Xiongsheng C,Giuffre JM.Single stage anterior cervical reconstruction with titanium mesh cages,local bone graft, and anterior plating. Spine J.2003;3:294-300. [8]Yue WM,Brodner W,Highland TR.Long-term results after anterior cervical discectomy and fusion with allograft and plating: a 5- to 11-year radiologic and clinical follow-up study.Spine (Phila Pa 1976).2005;30:2138-2144. [9]Hodges SD,Humphreys SC, Eck JC,et al.A modified technique for anterior multilevel cervical fusion.J Orthop Sci. 2002;7:313-316. [10]Fraser JF,Hartl R.Anterior approaches to fusion of the cervical spine: a metaanalysis of fusion rates.J Neurosurg Spine. 2007; 6:298-303. [11]Scholz M,Schnake KJ,Pingel A,et al.A new zero-profile implant for standalone anterior cervical interbody fusion.Clin Orthop Relat Res.2011;469:666-673. [12]Yue WM,Brodner W,Highland TR.Persistent swallowing and voice problems after anterior cervical discectomy and fusion with allograft and plating: a 5- to 11-year follow-up study.Eur Spine J.2005;14:677-682. [13]Smith-Hammond CA,New KC,Pietrobon R,et al.Prospective analysis of incidence and risk factors of dysphagia in spine surgery patients: comparison of anterior cervical, posterior cervical, and lumbar procedures.Spine (Phila Pa 1976). 2004; 29:1441-1446. [14]Mayr MT,Subach BR,Comey CH,et al.Cervical spinal stenosis: outcome after anterior corpectomy, allograft reconstruction, and instrumentation.J Neurosurg. 2002;96:10-16. [15]Miller LE,Block JE.Safety and effectiveness of bone allografts in anterior cervical discectomy and fusion surgery.Spine (Phila Pa 1976).2011;36:2045-2050. [16]Virk S,Sandhu HS,Khan SN.Cost effectiveness analysis of graft options in spinal fusion surgery using a Markov model.J Spinal Disord Tech.2012;25:E204-210. [17]Zhou J,Xia Q,Dong J,et al.Comparison of stand-alone polyetheretherketone cages and iliac crest autografts for the treatment of cervical degenerative disc diseases. Acta Neurochir(Wien).2011;153:115-122. [18]Patel NP,Wolcott WP,Johnson JP,et al.Esophageal injury associated with anterior cervical spine surgery.Surg Neurol.2008;69(1):20-24; discission 4. Epub 2007/11/03. [19]Buttermann GR.Prospective nonrandomized comparison of an allograft with bone morphogenic protein versus an iliac-crest autograft in anterior cervical discectomy and fusion.Spine J.2008;8:426-435. [20]Sansur CA,Early S,Reibel J,et al.Pharyngocutaneous fistula after anterior cervical spine surgery.Eur Spine J. 2009;18(5): 586-591. [21]Rafael H.Cervical spondylotic myelopathy: surgical results and factors affecting outcome with special reference to age differences.Neurosurgery.2003;53:787. [22]Matz PG,Anderson PA,Holly LT,et al.The natural history of cervical spondylotic myelopathy.J Neurosurg Spine.2009;11: 104-111. [23]Yan D,Wang Z,Deng S,et al.Anterior corpectomy and reconstruction with titanium mesh cage and dynamic cervical plate for cervical spondylotic myelopathy in elderly osteoporosis patients.Arch Orthop Trauma Surg. 2011;131: 1369-1374. [24]Amaral SH,Silva MN,Giraldi M,et al.Multiple cervical arcocristectomies for the treatment of cervical spondylotic myelopathy: surgical technique and results. J Neurosurg Spine.2007;7:503-508. [25]Hwang SL,Lee KS,Su YF,et al.Anterior corpectomy with iliac bone fusion or discectomy with interbody titanium cage fusion for multilevel cervical degenerated disc disease.J Spinal Disord Tech.2007;20:565-570. [26]Liu Y,Hou Y,Yang L,et al.Comparison of three reconstructive techniques in the surgical management of multilevel cervical spondylotic myelopathy.Spine (Phila Pa 1976). 2012;37: E1450-E1458. [27]Azab W,Abdel-Razek M,Ali A,et al.Outcome evaluation of a zeroprofile implant for anterior cervical diskectomy with fusion. Turk Neurosurg.2012;22:611-617. [28]Kristof RA,Kiefer T,Thudium M,et al.Comparison of ventral corpectomy and plate-screw-instrumented fusion with dorsal laminectomy and rod-screw-instrumented fusion for treatment of at least two vertebral level spondylotic cervical myelopathy. Eur Spine J.2009;18:1951-1956. [29]Hussain M,Natarajan RN,Fayyazi AH,et al.Screw angulation affects bone-screw stresses and bone graft load sharing in anterior cervical corpectomy fusion with a rigid screw-plate construct: a finite element model study.Spine J. 2009;9: 1016-1023. [30]Marawar S,Girardi FP,Sama AA,et al.National trends in anterior cervical fusion procedures.Spine (Phila Pa 1976). 2010;35:1454-459. [31]Angevine PD,Arons RR,McCormick PC.National and regional rates and variation of cervical discectomy with and without anterior fusion, 1990-1999.Spine (Phila Pa 1976). 2003;28: 931-940. [32]Jiang SD,Jiang LS,Dai LY.Anterior cervical discectomy and fusion versus anterior cervical corpectomy and fusion for multilevel cervical spondylosis: a systematic review.Arch Orthop Trauma Surg.2012;132:155-161. [33]Daniels AH,Riew D,Yoo JU,et al.Adverse events associated with anterior cervical spine surgery.J Am Acad Orthop Surg. 2008;16:729-738. [34]Yang B,Li H,Zhang T,et al.The incidence of adjacent segment degeneration after cervical disc arthroplasty (CDA): a meta analysis of randomized controlled trials. PLoS One. 2012;7: e35-32. [35]Klein GR,Vaccaro AR,Albert TJ.Health outcome assessment before and after anterior cervical discectomy and fusion for radiculopathy: a prospective analysis. Spine (Phila Pa 1976). 2000;25:801-803. [36]Hillard VH,Apfelbaum RI.Surgical management of cervical myelopathy: indications and techniques for multilevel cervical discectomy.Spine J.2006;6:242S-251S. |
[1] | Tang Xiaokai, Li Weiming. Role and mechanism of Nel-like molecule-1 in promoting bone fusion after spinal fusion [J]. Chinese Journal of Tissue Engineering Research, 2021, 25(24): 3914-3920. |
[2] | Cheng Yanan, Wu Yucong, Mao Qiuhua, Chen Ling, Lu Liying, Xu Pu. Restoration effect and stability of resin infiltration combined with bioactive glass on demineralized tooth enamel [J]. Chinese Journal of Tissue Engineering Research, 2021, 25(22): 3522-3526. |
[3] | Wang Hongyuan, Wang Wei, Yang Shuqing, Dou Lixin, Liu Lijun. Preparation and properties of porous nitrogen oxygen bioglass scaffold for bone repair [J]. Chinese Journal of Tissue Engineering Research, 2021, 25(16): 2521-2527. |
[4] | Chen Jiang, Li Jinyu, Zheng Chenying, Bai Chunxiao, Zhang Fan, Liu Chuyin, Zhao Xueqian, Yuan Qiaomei, Di Xueshi, Kang Shengqian, Jia Yusong . Changes in sagittal parameters of cervical spine after double-segment artificial cervical disc replacement and anterior cervical discectomy and fusion [J]. Chinese Journal of Tissue Engineering Research, 2021, 25(15): 2341-2346. |
[5] | Ding Jie, Li Xinying, Li Peng. Stress relaxation and creep test of modified glass ionomer cement [J]. Chinese Journal of Tissue Engineering Research, 2020, 24(22): 3515-3520. |
[6] | Lu Peiling, Feng Chunchao, Liang Miaomiao, Wei Jiatian, Huang Jing, Cai Haiming, Wu Guohui, Zhang Linghua, Nie Yunfei. Separation of adipose-derived stromal vascular fraction cells by a variety of physical methods: a comparative study [J]. Chinese Journal of Tissue Engineering Research, 2020, 24(13): 1976-1982. |
[7] | Cao Liangliang, Xu Jianguang, Mei Wei. Three-dimensional finite element analysis of the biomechanical changes of the lumbar spine after the combination of intervertebral fusion with dynamic internal fixation of the interspinous process in the lumbosacral region [J]. Chinese Journal of Tissue Engineering Research, 2020, 24(12): 1905-1910. |
[8] | Wang Liang, Li Lijun, Zhu Fuliang, Jiang Zhuyan, Wang Shuai, Ni Dongkui . Cortical bone trajectory screw versus pedicle screw fixation after posterior lumbar interbody fusion: a meta-analysis [J]. Chinese Journal of Tissue Engineering Research, 2019, 23(8): 1291-1298. |
[9] | Liang Long, Wei Xu, Zhu Liguo, Yin He, Yu Jie, Feng Minshan, Chen Lin. Cervical posterior single-door laminoplasty versus double-door laminoplasty for cervical spondylotic myelopathy: a meta-analysis [J]. Chinese Journal of Tissue Engineering Research, 2019, 23(8): 1299-1306. |
[10] | Li Qingsong, Liu Shaoyu, Yin Zongsheng. Multiple posterior lumbar interbody fusion and posterolateral fusion instrumentation for thoracolumbar kyphosis and osteoporotic fracture in older adults [J]. Chinese Journal of Tissue Engineering Research, 2019, 23(4): 512-517. |
[11] | Li Xianzhou, Wang Qian, Zhang Cunxin . Lumbar spondylolisthesis: status and prospects of implant treatment [J]. Chinese Journal of Tissue Engineering Research, 2019, 23(4): 621-627. |
[12] | Ma Lijuan, Deng Jiupeng, Yin Haoyue, Tian Yiwen. Preparation of polylactic acid/bioactive glass composite material by vacuum freeze-drying technique and study on its performance [J]. Chinese Journal of Tissue Engineering Research, 2019, 23(30): 4793-4798. |
[13] | Yi Guoliang, Wang Shankun, Song Xizheng. Biomechanical testing of the locking axial lumbosacral interbody fusion [J]. Chinese Journal of Tissue Engineering Research, 2019, 23(28): 4546-4551. |
[14] | Xiao Yan . Glass fiber post versus mental post and core for repair of external force-caused dental injury [J]. Chinese Journal of Tissue Engineering Research, 2019, 23(26): 4165-4169. |
[15] | Zhou Han, Hui Min, Miao Detian, Wang Le, Dong Xiling, Zhang Xiaoming. Effect of surface treatment reagents and treatment time on bond strength of glass fiber posts to resin cement [J]. Chinese Journal of Tissue Engineering Research, 2019, 23(18): 2852-2857. |
Viewed | ||||||
Full text |
|
|||||
Abstract |
|
|||||