Vukić Miroslav, Walters Beverly C, Radić Ankica, Jurjević Ivana, Marasanov Sergej M, Rozanković Marjan, Jednacak Hrvoje
University of Zagreb, School of Medicine, Department of Neurosurgery, Zagreb, Croatia.
Coll Antropol. 2011 Jan;35 Suppl 1:275-9.
The aim of this study is to evaluate the efficacy of hydroxyapatite grafts in multilevel cervical interbody fusion during the one year follow-up. A total of 86 patients with degenerative cervical disc disease underwent all together 224 cervical interbody fusion procedures in which either Smith-Robinson or Cloward type hydroxyapatite grafts were used. The surgeries included radiculopathy in 38 cases, myelopathy in 20 cases and myeloradicuopathy in 28 patients. In 65 out of 86 patients, fusion was followed by an anterior instrumentation (plating). Postoperatively, patients were followed for a mean of 15.64 (range 11-23.3) months. All patients underwent radiography to evaluate fusion and the axis curvature. Excellent clinical results (86%), described as a complete or partial relief of symptoms with full return to preop activity, were obtained in patients with radiculopathy. There were 5 grafts mobilizations and one graft fracture. Two grafts extruded in non-instrumented patients and required repeated surgery. There were other three reoperations due to the hardware problems. One year fusion rate was obtained at 86% for two-level surgery, 80.1% for three-level surgery and 74% for four-level surgery. The mean (SD) hospital stay was 3.8 (0.7) days. A hydroxyapatite cheramic can be a very effective synthetic material for multilevel cervical interbody fusion. It is characterized by a high fusion rate and a small percentage of graft-related complications, especially when fusion procedure is followed by plating.
本研究的目的是评估羟基磷灰石移植物在多节段颈椎椎间融合术一年随访期内的疗效。共有86例退行性颈椎间盘疾病患者总共接受了224例颈椎椎间融合手术，其中使用了Smith-Robinson型或Cloward型羟基磷灰石移植物。手术包括38例神经根病、20例脊髓病和28例脊髓神经根病。86例患者中有65例在融合术后进行了前路内固定（钢板固定）。术后，患者平均随访15.64（范围11 - 23.3）个月。所有患者均接受X线检查以评估融合情况和颈椎曲度。神经根病患者获得了优异的临床结果（86%），表现为症状完全或部分缓解且完全恢复术前活动。有5例移植物松动和1例移植物骨折。2例移植物在未进行内固定的患者中脱出，需要再次手术。另有3例因硬件问题进行了再次手术。两级手术的一年融合率为86%，三级手术为80.1%，四级手术为74%。平均（标准差）住院时间为3.8（0.7）天。羟基磷灰石陶瓷对于多节段颈椎椎间融合术可能是一种非常有效的合成材料。其特点是融合率高且与移植物相关的并发症比例小，尤其是在融合术后进行钢板固定时。
