Jenis L G, An H S, Simpson J M
Department of Orthopaedic Surgery, New England Baptist Hospital, Boston, Massachusetts 02120, USA.
J Spinal Disord. 2000 Oct;13(5):369-73. doi: 10.1097/00002517-200010000-00001.
The authors performed a prospective study of 63 patients with cervical radiculopathy treated with Robinson anterior cervical discectomy and fusion and compared the traditional or standard and reverse graft techniques. Modifications of the standard Robinson grafting techniques have been proposed. The reverse graft technique has theoretical advantages, including limiting the deleterious effects of graft extrusion and maintaining rigid middle column support. A radiographic evaluation and an assessment of clinical outcome based on the criteria of Odom were performed prospectively for as long as 1 year after surgery. Thirty-one patients were treated with the standard grafting technique and 32 with the reverse graft orientation. The radiographic evaluation showed no significant differences between the two techniques with regard to sagittal alignment and disk heights. The overall fusion grade was higher in the reverse graft technique (p < 0.05). There were 93% and 96% good to excellent results in the standard graft and reverse graft groups, respectively. The authors report no significant differences associated with the standard or reverse anterior cervical grafting techniques in terms of radiographic alignment or disk height loss over time or at early clinical outcome. However, improved fusion grade was noted with the reverse graft technique, which may be related to end plate and intervertebral space preparation. The reverse grafting technique is an acceptable alternative to the standard graft orientation.
作者对63例行Robinson前路颈椎间盘切除融合术治疗的神经根型颈椎病患者进行了一项前瞻性研究，比较了传统或标准植骨技术与反向植骨技术。有人提出了对标准Robinson植骨技术的改进。反向植骨技术具有理论上的优势，包括限制植骨块挤出的有害影响以及维持中柱的刚性支撑。术后长达1年，前瞻性地进行了影像学评估，并根据Odom标准对临床结果进行了评估。31例患者采用标准植骨技术治疗，32例采用反向植骨方向治疗。影像学评估显示，两种技术在矢状位对线和椎间盘高度方面无显著差异。反向植骨技术的总体融合等级更高（p<0.05）。标准植骨组和反向植骨组的优良率分别为93%和96%。作者报告称，就影像学对线、随时间推移或早期临床结果中的椎间盘高度丢失而言，标准或反向前路颈椎植骨技术之间无显著差异。然而，反向植骨技术的融合等级有所提高，这可能与终板和椎间隙准备有关。反向植骨技术是标准植骨方向的一种可接受的替代方法。
