Economical Analysis of Cervical Disc Disease by Anterior Inter-body Fusion Methods - Comparing of Bone Graft vs Plating -

경추간판 탈출 환자의 전방 고정술에 따른 경제적 분석 - 골 이식법과 금속판 고정 병행술의 비교 -

  • Gill, Seung-Bae (Department of Neurosurgery, Kangnung Hospital, ASAN Foundation. ULSAN University College of Medicine) ;
  • Lee, Sang-Youl (Department of Neurosurgery, Kangnung Hospital, ASAN Foundation. ULSAN University College of Medicine) ;
  • Heo, Seung-Ho (Department of Neurosurgery, Kangnung Hospital, ASAN Foundation. ULSAN University College of Medicine) ;
  • Jang, Yeun-Gyu (Department of Neurosurgery, Kangnung Hospital, ASAN Foundation. ULSAN University College of Medicine)
  • 길승배 (울산대학교 의과대학 아산재단 강릉병원 신경외과학교실) ;
  • 이상열 (울산대학교 의과대학 아산재단 강릉병원 신경외과학교실) ;
  • 허승호 (울산대학교 의과대학 아산재단 강릉병원 신경외과학교실) ;
  • 장연규 (울산대학교 의과대학 아산재단 강릉병원 신경외과학교실)
  • Received : 2000.09.19
  • Accepted : 2001.04.06
  • Published : 2001.02.28

Abstract

Objective : The purpose of this study was to assess the complications, duration of admission, cost effectiveness, radiologic stabilization of the anterior cervical bone fusion in the treatment of cervical disc disease with and without plating. Materials and Methods : Fifty-two surgically treated patients for cervical disc disease were reviewed. Group I consisted of consecutive treated patients with iliac auto-bone graft without instrumentation after anterior cervical discectomy. Group II consisted of consecutive treated patients with iliac autologous-bone graft with CASPER cervical plate fixations. Radiologic fusion was decided when loss of end plate boundary between graft bone and vertebral body and immobile, maintenance of the disc space were evident on simple dynamic plain films. The patients were discharged after the stabilization of cervical motion by films was of tained. These groups were analysed multiple variably with Mann-Whitney U-test. Results : Group I consisted of 18 patients, group II consisted of 34 patients. Mean age was $49.0{\pm}8.1years$, mean duration of admission was $17.27{\pm}10.51days$, mean costs for treatment was $1,970,000{\pm}475,000won$. In group I, mean age was 47.7(34-60) years, 16 patients had undergo on one-level operation, 2-patients had undergo on two-level operation, mean duration of admission was $28.7{\pm}10.4days$, mean costs for treatment was $2,194,473{\pm}561,639won$. The periods of stabilization was $6.6{\pm}3.36weeks$ on radiologic study. Mean periods of out patient follow up was 16.8(6-64) weeks after discharge. Mean period of radiologic follow up was 17.3(4-6) weeks after surgical operation. In group II, mean age was 49.7(37-62) years and 18 patients one-level operation, 14- patients had undergo on two-level operation and 2-patients three-level operation. Mean duration of admission was $11.24{\pm}3.29days$, mean costs for treatment was $1,850,823{\pm}389,372won$. The periods of stabilization was $5.88{\pm}7.07weeks$ on radiologic study. Mean period of out patients follow up was 16.7(4-60) weeks after discharge. Mean period of radiologic follow up was 12.4(3-52) weeks after surgical operation. The duration of admission showed statistical significance in Group II but other items showed no significant difference between two groups. Conclusions : The more economic, early life return and effective method of cervical disc disease in our series were evident in patients who had undergone, iliac bone graft and plate fixations after anterior discectomy.

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