Aydin Yunus, Çavusoglu Halit, Yüce Ismail, Özdilmaç Ahmet, Kahyaoglu Okan
Clinic of Neurosurgery, Acibadem University, Acibadem Fulya Hospital, Istanbul, Turkey.
Neurosurgery. 2017 Oct 1;81(4):627-637. doi: 10.1093/neuros/nyx056.
Any surgical procedure aims at protecting mobile segments at the operated level, and the sagittal balance of the columna vertebralis. Interbody fusion has become an often applied technique in anterior cervical discectomy.
To indicate that a minimally invasive technique in which we use interbody fat graft placement showed great results and effectiveness, especially in patients who were suffering from cervical paramedian disc herniation.
In this study, 432 patients were observed from 2000 to 2013. All these consecutive patients had paramedian disc herniation. The initial 239 patients (group 1) underwent microdiscectomy without graft placement, whereas the remaining 193 patients (group 2) had a microdiscectomy with interbody fat graft insertion. The Neck Disability Index (NDI) and Short Form-36 (SF-36) were used to evaluate clinical outcomes. They were followed up for 5.3 years (range 2-13 years).
Spontaneous radiological fusion was noticed in 12% of group 1 patients and none of the group 2 patients. It has been observed that the mean overall cervical curvature (C2-7) angles and segmental lordosis did not change significantly in late follow-up findings. During both early and late follow-ups, all patients indicated a decreasing NDI score, but in late follow-up, an improving SF-36 score.
This surgical technique provides good direct decompression and preserves mobility at the treated level, while preventing disc collapse.
任何外科手术的目的都是保护手术节段的活动节段以及脊柱的矢状位平衡。椎间融合术已成为颈椎前路椎间盘切除术中常用的技术。
表明我们采用椎间脂肪移植置入的微创技术取得了良好的效果和有效性，尤其是在患有颈椎旁中央型椎间盘突出症的患者中。
本研究观察了2000年至2013年期间的432例患者。所有这些连续患者均患有旁中央型椎间盘突出症。最初的239例患者（第1组）接受了无植骨的显微椎间盘切除术，而其余193例患者（第2组）接受了显微椎间盘切除术并置入椎间脂肪移植。采用颈部功能障碍指数（NDI）和简明健康调查问卷（SF-36）评估临床结果。对他们进行了5.3年的随访（范围为2至13年）。
第1组患者中有12%出现了自发的影像学融合，而第2组患者中无一例出现。观察发现，在晚期随访结果中，平均颈椎总曲度（C2-7）角度和节段性前凸没有明显变化。在早期和晚期随访期间，所有患者的NDI评分均下降，但在晚期随访时，SF-36评分有所提高。
该手术技术可提供良好的直接减压效果，保留治疗节段的活动度，同时防止椎间盘塌陷。
