McAfee Paul C, Lee Guy A, Fedder Ira L, Cunningham Bryan W
Scoliosis and Spine Center, Towson, MD, USA.
Clin Orthop Relat Res. 2002 Jan(394):55-63. doi: 10.1097/00003086-200201000-00007.
Beginning in January 1994, a prospective, clinical study was done comparing the effectiveness of complete anterior (Group 1) versus partial reamed channel discectomies (Group 2) in 100 consecutive patients who had anterior BAK instrumentation and fusion using autogenous iliac crest bone graft. At 2 or more years of followup, all patients in Group 1 who had complete operative disc removal achieved solid arthrodesis. There were no revision surgeries. However, in Group 2, there were seven patients who had a pseudarthrosis and an additional patient with early postoperative cage displacement, which resulted in eight patients in Group 2 requiring revision surgery. The differences in operative preparation of the disc space for BAK instrumentation surgery resulting in complications proved to be significant. The use of interbody titanium cages dramatically increases the biomechanical efficacy of anterior fusions. Original proponents of cages advocated removing a cylindrical channel of disc material using a drill. A prospective review of 100 patients who had complete versus partial discectomy revealed 14% of patients in Group 2 eventually had a pseudarthrosis develop.
从1994年1月开始，进行了一项前瞻性临床研究，比较100例连续接受前路BAK器械固定及自体髂嵴骨移植融合手术患者中，完全前路椎间盘切除术（第1组）与部分扩孔椎间盘切除术（第2组）的疗效。在随访2年或更长时间时，第1组所有接受完整手术椎间盘切除的患者均实现了牢固的关节融合。无翻修手术。然而，在第2组中，有7例患者发生假关节，另有1例患者术后早期椎间融合器移位，导致第2组有8例患者需要翻修手术。BAK器械手术椎间盘间隙手术准备方面导致并发症的差异被证明具有显著性。椎间钛笼的使用显著提高了前路融合的生物力学效能。椎间融合器的最初支持者主张使用钻头去除圆柱形椎间盘材料通道。对100例接受完全与部分椎间盘切除术患者的前瞻性回顾显示，第2组最终有14%的患者发生假关节。
