Jain Vaibhav, Madan Ankit, Thakur Manoj, Thakur Amit
Department of Orthopaedics, All India Institute of Medical Sciences Bhopal, Bhopal, India.
Department of Orthopaedics, Indira Gandhi Medical College Shimla, Shimla, India.
Neurospine. 2018 Dec;15(4):368-375. doi: 10.14245/ns.1836100.050. Epub 2018 Oct 15.
To evaluate the results of operative management of subaxial spine injuries managed with 2-level anterior cervical corpectomy and fusion with a cervical locking plate and autologous bone-filled titanium mesh cage.
This study included 23 patients with a subaxial spine injury who matched the inclusion criteria, underwent 2-level anterior cervical corpectomy and fusion at our institution between 2013 and 2016, and were followed up for neurological recovery, axial pain, fusion, pseudarthrosis, and implant failure.
According to Allen and Ferguson classification, there were 9 cases of distractive extension; 4 of compressive extension; 3 each of compressive flexion, vertical compression, and distractive flexion; and 1 of lateral flexion. Sixteen patients had a score of 6 on the Subaxial Injury Classification system, and the rest had a score of more than 6. The mean follow-up period was 19 months (range, 12-48 months). Neurological recovery was observed in most of the patients (78.21%). All patients experienced relief of axial pain. None of the patients received a blood transfusion. Twenty-one patients (91.3%) showed solid fusion and 2 (8.69%) showed possible pseudarthrosis, with no complications related to the cage or plate.
Two-level anterior cervical corpectomy and fusion, along with stabilization with a cervical locking plate and autologous bone graft-filled titanium mesh cage, can be considered a feasible and safe method for treating specific subaxial spine injuries, with the benefits of high primary stability, anatomical reduction, and direct decompression of the spinal cord.
评估采用两节段颈椎椎体次全切除、颈椎锁定钢板及自体骨填充钛网融合器融合术治疗下颈椎损伤的手术效果。
本研究纳入23例符合纳入标准的下颈椎损伤患者，于2013年至2016年在我院接受两节段颈椎椎体次全切除及融合术，并对其神经功能恢复、轴性疼痛、融合情况、假关节形成及植入物失败情况进行随访。
根据艾伦和弗格森分类法，牵张伸展型9例；压缩伸展型4例；压缩屈曲型、垂直压缩型及牵张屈曲型各3例；侧屈型1例。16例患者在下颈椎损伤分类系统中的评分为6分，其余患者评分高于6分。平均随访时间为19个月（范围12 - 48个月）。大多数患者（78.21%）神经功能得到恢复。所有患者轴性疼痛均缓解。无一例患者接受输血。21例患者（91.3%）显示融合良好，2例（8.69%）可能存在假关节形成，未出现与融合器或钢板相关的并发症。
两节段颈椎椎体次全切除及融合术，联合颈椎锁定钢板及自体骨移植填充钛网融合器进行固定，可被认为是治疗特定下颈椎损伤的一种可行且安全的方法，具有初始稳定性高、解剖复位及直接减压脊髓的优点。
