Cosar Murat, Ozer Ali Fahir, Iplikcioglu Ahmet Celal, Oktenoglu Tunc, Kosdere Serkan, Sasani Mehdi, Bozkus Hakan, Khoo Larry T, Sarioglu Ali Cetin
Neurosurgery Department, Faculty of Medicine, Kocatepe University, Afyonkarahisar.
J Spinal Disord Tech. 2008 Aug;21(6):436-41. doi: 10.1097/BSD.0b013e318157d365.
The efficacy of tricalcium phosphate and hydroxyapatite (beta-TCP/HA) grafts was studied after anterior cervical discectomy (ACD).
This study presents our observations about the efficacy of beta-TCP/HA grafts after ACD.
Especially in the last 2 decades, fusion materials such as autograft and allograft, as well as different kind of cages were used to maintain fusion after ACD.
beta-TCP/HA grafts after ACD were used in 17 patients. The cervical and radicular pain was evaluated via visual analog scale (VAS) score preoperatively, at postoperative third week, and after 20 months (range: 18 to 24 mo) after the operation. The radiologic evaluations were done preoperatively, at postoperative first day and at the latest follow-up. The VAS, intervertebral space ratio, height of intervertebral disc space and neural foramen, and cervical and segmental lordosis angles were recorded preoperatively and during the postoperative follow-up period. The presence of fusion was controlled in computed tomography scans taken at the latest follow-up.
Both clinical and radiologic evaluations yielded satisfactory results. VAS scores decreased significantly in all patients. The intervertebral space and neural foramen and intervertebral disc heights increased at postoperative day 1 but were found to be decreased at the latest follow-up (P<0.05). On the contrary the cervical and segmental lordosis angles decreased at postoperative day 1 but were found to be increased at the latest follow-up (P<0.05). There was a solid fusion in 16 out of 17 patients (94.11%).
Although there was a loss of the initially obtained neural foraminal and disc height, the application of beta-TCP/HA graft after ACD resulted in a high rate of fusion and patient satisfaction. Additionally, the cervical and segmental lordosis was preserved. We concluded that it is a good alternative to current methods to maintain cervical alignment and fusion after ACD.
在颈椎前路椎间盘切除术后（ACD），研究磷酸三钙和羟基磷灰石（β - TCP/HA）移植物的疗效。
本研究展示了我们对颈椎前路椎间盘切除术后β - TCP/HA移植物疗效的观察结果。
尤其是在过去的20年里，自体骨移植和同种异体骨移植等融合材料，以及不同类型的椎间融合器被用于颈椎前路椎间盘切除术后维持融合。
17例患者在颈椎前路椎间盘切除术后使用β - TCP/HA移植物。术前、术后第3周以及术后20个月（范围：18至24个月）通过视觉模拟量表（VAS）评分评估颈部和神经根性疼痛。术前、术后第1天以及最新随访时进行影像学评估。记录术前和术后随访期间的VAS评分、椎间隙比值、椎间盘间隙和神经孔高度以及颈椎和节段性前凸角度。在最新随访时进行的计算机断层扫描中检查融合情况。
临床和影像学评估均取得满意结果。所有患者的VAS评分均显著降低。术后第1天椎间隙、神经孔和椎间盘高度增加，但在最新随访时发现有所降低（P<0.05）。相反，术后第1天颈椎和节段性前凸角度降低，但在最新随访时发现有所增加（P<0.05）。17例患者中有16例（94.11%）实现了牢固融合。
尽管最初获得的神经孔和椎间盘高度有所丢失，但颈椎前路椎间盘切除术后应用β - TCP/HA移植物导致了较高的融合率和患者满意度。此外，颈椎和节段性前凸得以保留。我们得出结论，在颈椎前路椎间盘切除术后维持颈椎对线和融合方面，它是当前方法的一个良好替代方案。
