Chen Jyi-Feng, Wu Chieh-Tsai, Lee Sai-Cheung, Lee Shih-Tseng
Department of Neurosurgery, Neurospinal Section, Chang Gung University, Medical College and Chang Gung Memorial Hospital, Taoyuan, Taiwan, Republic of China.
J Neurosurg Spine. 2006 Oct;5(4):287-93. doi: 10.3171/spi.2006.5.4.287.
This prospective study was conducted to assess the safety of using a cylindrical polymethylmethacrylate (PMMA) strut for fusion and reconstruction of the cervical spine after single-level cervical corpectomy. The authors describe the clinical results obtained in patients after surgery.
Fifty-four patients underwent single-level cervical corpectomy, fusion, and spinal reconstruction that involved the placement of hollow cylindrical PMMA struts. In each patient, the spine was reinforced with anterior cervical plates. The PMMA struts were filled with autologous bone obtained from the resected vertebral body. Follow-up radiographic evaluation involved plain lateral dynamic radiographs and computed tomography (CT) scans. Neurological status was assessed pre- and postoperatively using the Nurick Scale. A total of 46 patients (85.1%) attended follow-up visits for a minimum of 2 years. Spinal stability was documented in all patients on 12-month plain dynamic lateral radiographs; in 37 patients (80.4%), complete osseous fusion was demonstrated on the 12-month CT reconstructions. In the remaining nine patients, complete fusion had been achieved by 24 months. The overall mean preoperative Nurick grade was 2.94 +/- 0.97, and this improved significantly to 1.71 +/- 0.77 (p < 0.05) by 24 months. There were no complications related to the hollow cylindrical PMMA strut.
The findings of this preliminary study indicate that hollow cylindrical PMMA struts can be safely used in cervical fusion after single-level corpectomy and that the clinical results are satisfactory. The hollow cylindrical PMMA strut is a good substitute for spinal reconstruction and fusion when combined with plate fixation in patients who have undergone anterior cervical single-level corpectomy.
本前瞻性研究旨在评估使用圆柱形聚甲基丙烯酸甲酯（PMMA）支撑物进行单节段颈椎椎体次全切除术后颈椎融合与重建的安全性。作者描述了术后患者的临床结果。
54例患者接受了单节段颈椎椎体次全切除、融合及脊柱重建手术，术中置入中空圆柱形PMMA支撑物。每位患者均使用前路颈椎钢板加强脊柱。PMMA支撑物内填充取自切除椎体的自体骨。随访影像学评估包括普通动态侧位X线片和计算机断层扫描（CT）。术前和术后使用Nurick量表评估神经功能状态。共有46例患者（85.1%）进行了至少2年的随访。所有患者在术后12个月的普通动态侧位X线片上均显示脊柱稳定；37例患者（80.4%）在术后12个月的CT重建中显示完全骨融合。其余9例患者在24个月时实现了完全融合。术前Nurick分级的总体平均评分为2.94±0.97，到24个月时显著改善至1.71±0.77（p<0.05）。未发生与中空圆柱形PMMA支撑物相关的并发症。
这项初步研究的结果表明，中空圆柱形PMMA支撑物可安全用于单节段椎体次全切除术后的颈椎融合，临床结果令人满意。对于接受前路单节段颈椎椎体次全切除术的患者，中空圆柱形PMMA支撑物与钢板固定联合使用时，是脊柱重建与融合的良好替代品。
