Kogure Kazunari, Isu Toyohiko, Node Yoji, Tamaki Tomonori, Kim Kyongsong, Morimoto Daijiro, Morita Akio
Department of Neurosurgery, Graduate School of Medicine, Nippon Medical School; 2. Department of Neurosurgery, Nippon Medical School Tama Nagayama Hospital. Japan.
J Nippon Med Sch. 2015;82(1):50-3. doi: 10.1272/jnms.82.50.
Anterior cervical fixation with autologous bone transplantation-without the need for harvesting bone from other sites, such as the ilium-was developed by Williams and modified by Isu et al. In recent intervertebral fusion procedures, after harvesting the cuboid bone from vertebral bodies, a hydroxyapatite block is placed between two harvested vertebral bones in the same way as in the sandwich method for intervertebral fixation. According to previous studies, this procedure has the following disadvantages: (i) as the corrective force for cervical kyphosis is insufficient, it could not be adapted for patients with preoperative kyphosis; (ii) special devices, including a microsurgical saw, are required for harvesting vertebral bones. In our modified method, we used a conventional high-speed drill instead of a microsurgical saw. Nevertheless, the results show that the operated spine can be stabilized to a greater extent by decreasing the height of the grafted bone, and this might help in reducing postoperative kyphosis.
Williams研发了前路颈椎自体骨移植固定术——无需从其他部位(如髂骨)取骨,Isu等人对其进行了改良。在最近的椎间融合手术中,从椎体获取立方形骨后,将羟基磷灰石块以与椎间固定三明治法相同的方式置于两块获取的椎骨之间。根据以往研究,该手术有以下缺点:(i)由于矫正颈椎后凸的力量不足,不适用于术前有后凸的患者;(ii)获取椎骨需要特殊器械,包括微型手术锯。在我们的改良方法中,我们使用传统高速钻代替微型手术锯。然而,结果表明,通过降低移植骨的高度,手术脊柱能在更大程度上实现稳定,这可能有助于减少术后后凸。