Schils Frédéric, Rilliet Benedict, Payer Michael
Department of Neurosurgery, University Hospital of Geneva, Switzerland.
J Neurosurg Spine. 2006 Apr;4(4):292-9. doi: 10.3171/spi.2006.4.4.292.
The authors conducted a study to evaluate and compare prospectively the implantation of either an empty carbon fiber composite frame cage (CFCFC) or an iliac crest autograft after anterior cervical discectomy (ACD) for cervical disc herniation with monoradiculopathy.
Thirty-six consecutive patients with one-level radiculopathy due to single-level cervical disc herniation were treated by ACD, and implantation of either an empty CFCFC (24 patients) or an iliac crest autograft (12 patients). Radiological and clinical assessments were performed preoperatively, immediately postoperatively, and at 3, 6, and 12 months postoperatively. Fusion at the 12-month follow-up examination was demonstrated in 96% of the patients in the cage group and in 100% of those in the autograft group. The mean anterior intervertebral body height was 3.7 mm preoperatively and 3.9 mm at 12 months in the CFCFC, and 4.1 and 3.8 mm, respectively, in the autograft group. In cage-treated patients, neck pain, as measured using the visual analog scale (VAS) (Score 0 = minimum; 10 = maximum) decreased from 6.4 preoperatively to 2.0 at 12 months, and radicular pain decreased from 8.4 preoperatively to 1.5 at 12 months. In the autograft group, neck pain changed from a mean preoperative VAS score of 7.2 to 2.5 at 12 months, and radicular pain decreased from a preoperative mean of 7.8 to 1.4 at 12 months. Analysis of the 12-Item Short Form Health Survey domains and the Oswestry Disability Index scores indicated a significant improvement in both the Physical and Mental Component Summary domains in both groups.
Implantation of an empty CFCFC or a tricortical iliac crest autograft after ACD are safe and reliable options for the treatment of cervical disc herniation causing one-sided radiculopathy. Both procedures produced equally satisfying clinical and radiological results, leading to a high fusion rate and maintaining intervertebral height. Implantation of an empty CFCFC has the advantages of avoiding any donor site morbidity and requiring a significantly shorter operative time.
作者进行了一项前瞻性研究，以评估和比较颈椎间盘突出症伴单神经根病行前路颈椎间盘切除术后植入空碳纤维复合框架笼（CFCFC）或髂嵴自体骨的效果。
36例因单节段颈椎间盘突出导致单节段神经根病的连续患者接受了前路颈椎间盘切除术，并植入空CFCFC（24例患者）或髂嵴自体骨（12例患者）。在术前、术后即刻以及术后3、6和12个月进行影像学和临床评估。在12个月的随访检查中，笼组96%的患者和自体骨组100%的患者显示融合。CFCFC组术前平均椎体前缘高度为3.7mm，12个月时为3.9mm；自体骨组分别为4.1mm和3.8mm 。在接受笼植入治疗的患者中，使用视觉模拟量表（VAS）（评分0 = 最低；10 = 最高）测量的颈部疼痛从术前的6.4分降至12个月时 的2.0分 ，神经根性疼痛从术前的8.4分降至12个月时的1.5分。在自体骨组中，颈部疼痛从术前VAS平均评分7.2分变为12个月时的2.5分，神经根性疼痛从术前平均7.8分降至12个月时的1.4分。对12项简短健康调查领域和Oswestry功能障碍指数评分的分析表明，两组的身体和心理成分总结领域均有显著改善。
前路颈椎间盘切除术后植入空CFCFC或三皮质髂嵴自体骨是治疗导致单侧神经根病的颈椎间盘突出症的安全可靠选择。两种手术均产生了同样令人满意的临床和影像学结果，导致高融合率并维持椎间高度。植入空CFCFC具有避免任何供区并发症和手术时间明显缩短的优点。
