颈椎前路钢板置入新技术要点：先钻孔，再选择合适的钢板尺寸。

New technical tip for anterior cervical plating : make hole first and choose the proper plate size later.

作者信息

Park Jeong Yoon, Zhang Ho Yeol, Oh Min Chul

机构信息

Department of Neurosurgery, Gangnam Severance Hospital, Spine and Spinal Cord Institute, Yonsei University College of Medicine, Seoul, Korea.

出版信息

J Korean Neurosurg Soc. 2011 Apr;49(4):212-6. doi: 10.3340/jkns.2011.49.4.212. Epub 2011 Apr 30.

DOI:10.3340/jkns.2011.49.4.212

PMID:21607178

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3098423/

Abstract

OBJECTIVE

It is well known that plate-to-disc distance (PDD) is closely related to adjacent-level ossification following anterior cervical plate placement. The study was undertaken to compare the outcomes of two different anterior cervical plating methods for degenerative cervical condition. Specifically, the new method involves making holes for plate screws first with an air drill and then choosing a plate size. The other method was standard, that is, decide on the plate size first, locate the plate on the anterior vertebral body, and then drilling the screw holes. Our null hypothesis was that the new technical tip may increase PDD as compared with the standard anterior cervical plating procedure.

METHODS

We retrospectively reviewed 49 patients who had a solid fusion after anterior cervical arthrodesis with a plate for the treatment of cervical disc degeneration. Twenty-three patients underwent the new anterior cervical plating technique (Group A) and 26 patients underwent the standard technique (Group B). PDD and ratios between PDD to anterior body heights (ABH) were measured using postoperative lateral radiographs. In addition, operating times and clinical results were reviewed in all cases.

RESULTS

The mean durations of follow-up were 16.42±5.99 (Group A) and 19.83±6.71 (Group B) months, range 12 to 35 months. Of these parameters mentioned above, cephalad PDD (5.43 versus 3.46 mm, p=0.005) and cephalad PDD/ABH (0.36 versus 0.23, p=0.004) were significantly greater in the Group A, whereas operation time for two segment arthrodesis (141.9 versus 170.6 minutes, p=0.047) was significantly lower in the Group A. There were no significant difference between the two groups in caudal PDD (5.92 versus 5.06 mm), caudal PDD/ABH (0.37 versus 0.32) and clinical results.

CONCLUSION

The new anterior cervical plating method represents an improvement over the standard method in terms of cephalad plate-to-disc distance and operating time.

摘要

目的

众所周知，颈椎前路钢板置入术后钢板与椎间盘的距离（PDD）与相邻节段骨化密切相关。本研究旨在比较两种不同的颈椎前路钢板置入方法治疗颈椎退变疾病的疗效。具体而言，新方法是先用气钻为钢板螺钉打孔，然后选择钢板尺寸。另一种方法是标准方法，即先确定钢板尺寸，将钢板置于椎体前方，然后钻螺钉孔。我们的零假设是，与标准颈椎前路钢板置入术相比，新技术可能会增加PDD。

方法

我们回顾性分析了49例颈椎前路融合术后使用钢板治疗颈椎间盘退变且获得牢固融合的患者。23例患者采用新的颈椎前路钢板置入技术（A组），26例患者采用标准技术（B组）。使用术后侧位X线片测量PDD以及PDD与椎体前高度（ABH）的比值。此外，对所有病例的手术时间和临床结果进行了评估。

结果

平均随访时间分别为A组16.42±5.99个月、B组19.83±6.71个月，范围为12至35个月。在上述参数中，A组的头侧PDD（5.43对3.46 mm，p = 0.005）和头侧PDD/ABH（0.36对0.23，p = 0.004）显著更高，而A组两节段融合的手术时间（141.9对170.6分钟，p = 0.047）显著更短。两组在尾侧PDD（5.92对5.06 mm）、尾侧PDD/ABH（0.37对0.32）和临床结果方面无显著差异。