Feng Rui, Loewenstern Joshua, Caridi John
Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
World Neurosurg. 2017 Sep;105:1041.e1-1041.e5. doi: 10.1016/j.wneu.2017.06.150. Epub 2017 Jul 1.
Cervical stand-alone interbody cages have seen increasingly wider use over the plate-and-screw construct in single-level anterior cervical discectomy and fusion (ACDF) in the treatment of cervical disc herniation and degenerative spondylotic conditions. Despite positive clinical outcomes, the efficacy and safety of using these devices in contiguous multilevel ACDF has remained controversial. This report discusses a burst fracture seen as a complication in multilevel cervical stand-alone cage use.
A 39-year-old woman with a history of C5-C6 and C6-C7 ACDF with contiguous stand-alone interbody cages 2 years prior, presented with recurrent arm and neck pain with myelopathy. Computed tomography scan revealed a burst fracture of the C6 vertebral body with retropulsion of fragments compressing the spinal cord.
This case suggests that use of cervical stand-alone cages in contiguous levels may cause late complications despite good instrumentation and illustrates the need for more careful consideration of technique selection in multilevel ACDF.
在单节段前路颈椎间盘切除融合术（ACDF）中，治疗颈椎间盘突出症和退行性脊椎病时，颈椎独立椎间融合器比钢板螺钉结构的应用越来越广泛。尽管临床效果良好，但在相邻多节段ACDF中使用这些器械的有效性和安全性仍存在争议。本报告讨论了在多节段颈椎独立椎间融合器使用中出现的爆裂骨折并发症。
一名39岁女性，2年前曾行C5-C6和C6-C7节段的ACDF，使用相邻的独立椎间融合器，现出现复发性手臂和颈部疼痛伴脊髓病。计算机断层扫描显示C6椎体爆裂骨折，骨折碎片后凸压迫脊髓。
该病例表明，尽管器械良好，但相邻节段使用颈椎独立椎间融合器可能会导致晚期并发症，这说明在多节段ACDF中需要更谨慎地考虑技术选择。
