Papadopoulos Elias C, Huang Russel C, Girardi Federico P, Synnott Keith, Cammisa Frank P
Hospital for Special Surgery, New York, NY 10021, USA.
Spine (Phila Pa 1976). 2006 Apr 15;31(8):897-902. doi: 10.1097/01.brs.0000209348.17377.be.
Retrospective review of patients with cervical spondylosis treated with 3-level anterior cervical discectomy and fusion with plate fixation.
To assess the radiographic and clinical outcome of 3-level instrumented anterior cervical discectomy.
Three-level cervical discectomy without plate fixation has shown high rates of pseudarthrosis and poor outcomes. The addition of internal fixation may improve these parameters.
A total of 46 patients were observed for an average of 17.6 months (range, 6-51 months). All had 3-level anterior cervical discectomy and fusion with tricortical iliac crest autograft (4 cases), fibular ring allograft (38 cases), or titanium cage (4 cases). Allografts and cages were filled with iliac crest autograft. All patients had semirigid plating. Clinical and radiographic follow-up data were obtained. Clinical outcomes were measured as described by Robinson and with the Nurick scale.
Forty-four patients achieved solid fusion. Two patients had additional surgery for junctional disease, and in 1 of them pseudarthrosis repair was also performed. One asymptomatic pseudarthrosis was noted. With a successful result defined as an excellent or good outcome accompanied by significant pain relief, 38 patients had a successful result (83%). Radiographic adjacent level disease was diagnosed in 11 patients after surgery and was symptomatic in 5.
Three-level anterior cervical discectomy with plate fixation has a high rate of fusion, a low complication rate, and acceptable outcome in the treatment of multilevel cervical spondylosis.
对接受三级颈椎前路椎间盘切除并植骨融合钢板内固定治疗的颈椎病患者进行回顾性研究。
评估三级颈椎前路椎间盘切除并使用内固定器械的影像学和临床疗效。
三级颈椎间盘切除不使用钢板固定已显示出较高的假关节形成率和较差的疗效。增加内固定可能会改善这些指标。
共观察46例患者，平均观察时间为17.6个月（范围6 - 51个月）。所有患者均接受三级颈椎前路椎间盘切除并融合，采用三面皮质髂嵴自体骨移植（4例）、腓骨环同种异体骨移植（38例）或钛笼（4例）。同种异体骨和钛笼均填充髂嵴自体骨。所有患者均采用半刚性钢板固定。获取临床和影像学随访数据。临床疗效按照罗宾逊描述的方法并使用努里克量表进行测量。
44例患者实现了坚固融合。2例患者因节段性疾病接受了二次手术，其中1例还进行了假关节修复。发现1例无症状假关节。将成功结果定义为优或良的结果且伴有明显疼痛缓解，38例患者获得成功结果（83%）。术后11例患者被诊断为影像学相邻节段疾病，其中5例有症状。
三级颈椎前路椎间盘切除并钢板固定在治疗多节段颈椎病方面具有较高的融合率、较低的并发症发生率和可接受的疗效。
