Wang J C, McDonough P W, Endow K K, Delamarter R B
Department of Orthopaedic Surgery, UCLA School of Medicine, Los Angeles, CA 90095-6902, U.S.A.
J Spinal Disord. 2001 Jun;14(3):222-5. doi: 10.1097/00002517-200106000-00006.
A single corpectomy and strut grafting has been proposed as an alternative to performing two-level adjacent discectomies with multiple grafts to produce superior fusion rates. The purpose of this study was to compare the clinical and radiographic success of two-level discectomy and fusion with anterior cervical plate fixation compared with a single-level corpectomy. Fifty-two patients were treated with either a two-level adjacent anterior cervical discectomy and fusion with cervical plating, or by a single-level corpectomy and plate. Thirty-two patients had two-level discectomies, whereas 20 had a single corpectomy and a strut graft (average follow-up was 3.6 years). One patient had a pseudarthrosis from a single-level corpectomy and required subsequent surgery to obtain an osseous union. The fusion rates between the two groups was not statistically significant (p = 0.385). The clinical results of the surgeries were similar between the groups based on Odom's criteria. The addition of cervical plates to either two-level discectomies or single-level corpectomies yielded similar fusion and complication rates.
有人提出，单次椎体切除及支撑植骨可作为一种替代方案，以取代进行两次相邻节段椎间盘切除术并使用多个移植物，从而获得更高的融合率。本研究的目的是比较两节段椎间盘切除术及融合并前路颈椎钢板固定与单节段椎体切除的临床及影像学成功率。52例患者接受了以下两种治疗之一：两节段相邻前路颈椎间盘切除术及融合并颈椎钢板固定，或单节段椎体切除及钢板固定。32例患者接受了两节段椎间盘切除术，而20例接受了单节段椎体切除及支撑植骨（平均随访3.6年）。1例接受单节段椎体切除的患者出现假关节形成，需要后续手术以实现骨融合。两组之间的融合率无统计学差异（p = 0.385）。根据奥多姆标准，两组手术的临床结果相似。在两节段椎间盘切除术或单节段椎体切除术中添加颈椎钢板，融合率及并发症发生率相似。
