O'Neill Conor N, Walterscheid Zakk J, Carmouche Jonathan J
Virginia Commonwealth University, Richmond, VA, USA.
University of Washington, Seattle, WA, USA.
Global Spine J. 2022 Mar;12(2):190-197. doi: 10.1177/2192568220947741. Epub 2020 Sep 29.
Case series.
Successful clinical outcome scores following anterior cervical discectomy and fusion (ACDF) have been correlated with high fusion rate. Published fusion rates using iliac crest bone graft (ICBG) have been shown to be as high as 100% for single-level fusions in some studies; however, there is potential associated morbidity with ICBG harvest. This technical description and preliminary case series assessed the clinical efficacy and results of a novel grafting technique for ACDF.
Twelve patients underwent novel grafting technique for ACDF in which autograft was procured from the cervical vertebra adjacent to the operative disk. Patients were followed for 2 years using visual analogue pain scale (VAS) and radiological assessment of fusion.
Patients experienced clinically meaningful reduction of radicular symptoms in the affected arm(s) with an average preoperative VAS score of 5.0 ± 0.8 and an average 2-year postoperative score of 1.108 ± 0.475 ( = .0013). Patients also experienced significant resolution of neck pain with an average preoperative VAS score of 7.1 ± 0.5 and average 2-year postoperative score of 2.708 ± 0.861 ( = .0018). All patients achieved solid fusion by 1 year. There were no major or minor complications noted during follow-up.
This procedure allows for both autograft harvest and cervical decompression to be performed through a single incision. In this series, this technique eliminated the morbidity associated with autograft harvest from the iliac crest while achieving high fusion rates and without additional technique-related complications.
病例系列。
颈椎前路椎间盘切除融合术(ACDF)术后成功的临床疗效评分与高融合率相关。一些研究表明,使用髂嵴骨移植(ICBG)的已发表融合率在单节段融合中高达100%;然而,ICBG采集存在潜在的相关发病率。本技术描述和初步病例系列评估了一种用于ACDF的新型移植技术的临床疗效和结果。
12例患者接受了用于ACDF的新型移植技术,其中自体移植物取自手术椎间盘相邻的颈椎椎体。使用视觉模拟疼痛量表(VAS)和融合的影像学评估对患者进行了2年的随访。
患者患侧手臂的神经根症状在临床上有显著减轻,术前平均VAS评分为5.0±0.8,术后2年平均评分为1.108±0.475(P = 0.0013)。患者的颈部疼痛也有显著缓解,术前平均VAS评分为7.1±0.5,术后2年平均评分为2.708±0.861(P = 0.0018)。所有患者在1年内均实现了牢固融合。随访期间未发现重大或轻微并发症。
该手术允许通过单一切口进行自体移植物采集和颈椎减压。在本系列中,该技术消除了与从髂嵴采集自体移植物相关的发病率,同时实现了高融合率且无额外的技术相关并发症。