Fuji T, Yonenobu K, Fujiwara K, Yamashita K, Ono K, Okada K
Spine (Phila Pa 1976). 1986 Dec;11(10):982-7. doi: 10.1097/00007632-198612000-00002.
Nine patients who had unsuccessful anterior interbody fusion or subtotal spondylectomy and fusion for cervical spondylosis were treated by interspinous wiring without bone grafting. Bone union was confirmed during a mean postoperative period of 2 years and 2 months in seven patients by the disappearance of clear zones observed preoperatively in the disc space, and by continuity of the trabeculae in radiograms. One of the two patients in whom the procedure failed to unite the site of nonunion had received technically inadequate wiring with slight mobility at the wiring site; in the other patient, the grafted bone had collapsed and no sclerotic shadow of the nonunion site was seen at the time of surgery. Both patients underwent wiring after considerable intervals from the time of the initial anterior spinal fusion. We found that satisfactory bone union can be obtained for nonunion or delayed union following anterior cervical spinal fusion by interspinous wiring without further bone grafting if applied to properly selected patients.
9例因前路椎间融合术失败或因颈椎病行椎体次全切除融合术失败的患者接受了棘突间钢丝固定术且未进行植骨。7例患者在术后平均2年2个月时通过术前椎间盘间隙清晰区域的消失以及X线片中小梁的连续性确认了骨愈合。在未能使骨不连部位愈合的2例患者中，有1例在钢丝固定技术上不充分，钢丝固定部位存在轻微活动；另一例患者，移植骨已塌陷，手术时未见到骨不连部位的硬化影。这2例患者均在初次前路脊柱融合术后相当长的间隔时间后才进行钢丝固定。我们发现，如果应用于适当选择的患者，通过棘突间钢丝固定术无需进一步植骨即可使颈椎前路融合术后的骨不连或延迟愈合获得满意的骨愈合。
