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生物可吸收前路颈椎钢板在治疗颈椎退行性和创伤性椎间盘破裂中的应用。

Use of a bioabsorbable anterior cervical plate in the treatment of cervical degenerative and traumatic disk disruption.

作者信息

Vaccaro Alexander R, Venger Benjamin H, Kelleher Peter M, Singh Kush, Carrino John A, Albert Todd, Hilibrand Alan

机构信息

Department of Orthopedic Surgery, Thomas Jefferson University, Rothman Institute, Philadelphia, PA, USA.

出版信息

Orthopedics. 2002 Oct;25(10 Suppl):s1191-9; discussion s1199. doi: 10.3928/0147-7447-20021002-11.

Abstract

Anterior cervical diskectomy and fusion is a widely accepted treatment for anterior management of degenerative or traumatic instability of the cervical spine. To reduce or eliminate complications such as implant migration and failure, imaging degradation, and fusion stress shielding that are occasionally associated with spinal instrumentation, attention has been given to the use of bioresorbable anterior cervical plating devices. This paper is a preliminary report of a retrospective series in which a resorbable mesh and screw system (OS Reconstructive Mesh, MacroPore Biosurgery Inc, San Diego, Calif) was used for graft containment in single-level anterior cervical diskectomy and fusion. A review of patient charts and imaging studies was conducted to determine functional outcome, fusion success, and potential soft-tissue reaction to implant resorption. Nine patients with a diagnosis of cervical degenerative disk disease or traumatic disk disruption were treated between October 2001 and March 2002. Follow-up averaged 206 days. Eight patients were found to have an excellent result, one patient had a good result, and no patients had a satisfactory or poor result. At the time of follow-up, 77% of patients (7/9) were found to have a radiographically solid fusion. The two patients without a solid fusion were only on average 8 months out from their fusion procedure and manifested no symptoms related to fusion nonhealing. No significant soft-tissue reaction was noted clinically or radiographically in any of the patients. The results of this preliminary study indicate that bioresorbable anterior cervical plating for single-level anterior cervical diskectomy and fusion is both safe and effective.

摘要

颈椎前路椎间盘切除融合术是治疗颈椎退变或创伤性不稳定的一种广泛接受的前路手术方法。为了减少或消除诸如植入物移位和失败、影像质量下降以及融合应力遮挡等偶尔与脊柱内固定相关的并发症,人们开始关注使用可生物吸收的颈椎前路钢板装置。本文是一项回顾性系列研究的初步报告,该研究使用了一种可吸收网片和螺钉系统(OS重建网片,MacroPore生物外科公司,加利福尼亚州圣地亚哥)用于单节段颈椎前路椎间盘切除融合术中的植骨固定。通过回顾患者病历和影像学研究来确定功能结果、融合成功率以及对植入物吸收的潜在软组织反应。2001年10月至2002年3月期间,对9例诊断为颈椎退行性椎间盘疾病或创伤性椎间盘破裂的患者进行了治疗。平均随访206天。发现8例患者结果优秀,1例患者结果良好,没有患者结果满意或差。在随访时,77%的患者(7/9)影像学显示融合牢固。2例未实现牢固融合的患者距融合手术平均仅8个月,且未表现出与融合不愈合相关的症状。在任何患者中,临床或影像学均未发现明显的软组织反应。这项初步研究的结果表明,可生物吸收的颈椎前路钢板用于单节段颈椎前路椎间盘切除融合术是安全有效的。

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