Journal of Korean Neurosurgical Society

  • 제51권3호
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  • Pages.135-140
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  • 2012
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  • 2005-3711(pISSN)
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  • 1598-7876(eISSN)
대한신경외과학회 (The Korean Neurosurgical Society)
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Radiographic Comparison of Four Anterior Fusion Methods in Two Level Cervical Disc Diseases : Autograft Plate Fixation versus Cage Plate Fixation versus Stand-Alone Cage Fusion versus Corpectomy and Plate Fixation

  • Kim, Min-Ki (Department of Neurosurgery, KyungHee University Hospital at Gangdong, School of Medicine, KyungHee University) ;
  • Kim, Sung-Min (Department of Neurosurgery, KyungHee University Hospital at Gangdong, School of Medicine, KyungHee University) ;
  • Jeon, Kwang-Mo (Department of Neurosurgery, KyungHee University Hospital at Gangdong, School of Medicine, KyungHee University) ;
  • Kim, Tae-Sung (Department of Neurosurgery, KyungHee University Hospital at Gangdong, School of Medicine, KyungHee University)
  • 투고 : 2011.04.18
  • 심사 : 2012.03.08
  • 발행 : 2012.03.28
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초록

Objective : To evaluate radiographic results of anterior fusion methods in two-level cervical disc disease : tricortical autograft and plate fixation (ACDF-AP), cage and plate fixation (ACDF-CP), stand-alone cage (ACDF-CA), and corpectomy and plate fixation (ACCF). Methods: The numbers of patients were 70 with a minimum 6 month follow-up (ACDF-AP : 12, ACDF-CP : 27, ACDF-CA : 15, and ACCF : 16). Dynamic simple X-ray and computed tomography were evaluated preoperatively, postoperatively, 6 month, and at the final follow-up. The fusion and subsidence rates at the final were determined, and global cervical lordosis (GCL), cervical range of motion, fused segment angle (FSA), and fused segment height (FSH) were analyzed. Results: Nonunion was observed in 4 (25%) patients with ACDF-CA, 1 (8%) patient with ACDF-AP, 1 (4%) patient with ACDF-CP. The number of loss of FSH (%) more than 3 mm were 2 patients (16%) in ACDF-AP, 3 patients (11%) in ACDF-CP, 5 patients (33%) in ACDF-CA, and 3 patients (20%) in ACCF. The GCL was decreased with ACDF-CA and increased with others. The FSA was increased with ACDF-AP, ACDF-CP, and ACCF, but ACDF-CA was decreased. At the final follow-up, the FSH was slightly decreased in ACDF-CP, ACDF-AP, and ACCF, but ACDF-CA was more decreased. Graft related complication were minimal. Screw loosening, plate fracture, cage subsidence and migration were not identified. Conclusion: ACDF-CP demonstrated a higher fusion rate and less minimal FSH loss than the other fusions in two-level cervical disc disease. The ACDF-AP and ACCF methods had a better outcome than the ACDF-CA with respect to GCL, FSA, and FSH.

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참고문헌

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피인용 문헌

  1. Vertebral body replacement with PEEK-cages after anterior corpectomy in multilevel cervical spinal stenosis: a clinical and radiological evaluation vol.134, pp.5, 2012, https://doi.org/10.1007/s00402-014-1972-1
  2. The influence of cervical plate fixation with either autologous bone or cage insertion on radiographic and patient-rated outcomes after two-level anterior cervical discectomy and fusion vol.24, pp.1, 2012, https://doi.org/10.1007/s00586-014-3456-y
  3. Autologous bone graft versus PEKK cage for vertebral replacement after 1- or 2-level anterior median corpectomy vol.24, pp.2, 2012, https://doi.org/10.3171/2015.5.spine14887
  4. Clinical outcomes of locking stand-alone cage versus anterior plate construct in two-level anterior cervical discectomy and fusion: a systematic review and meta-analysis vol.28, pp.1, 2019, https://doi.org/10.1007/s00586-018-5811-x
  5. Cages in ACDF are Associated With a Higher Nonunion Rate Than Allograft : A Stratified Comparative Analysis of 6130 Patients vol.44, pp.6, 2019, https://doi.org/10.1097/brs.0000000000002854
  6. Anterior Surgical Techniques for Cervical Spondylotic Myelopathy: World Federation of Neurosurgical Societies Spine Committee Recommendations vol.16, pp.3, 2012, https://doi.org/10.14245/ns.1938250.125
  7. Anterior cervical discectomy and fusion for cervical myelopathy using stand-alone tricortical iliac crest autograft: Predictive factors for neurological and fusion outcomes vol.27, pp.3, 2012, https://doi.org/10.1177/2309499019869166
  8. Determining the Difference in Clinical and Radiologic Outcomes Between Expandable and Nonexpandable Titanium Cages in Cervical Fusion Procedures: A Systematic Review and Meta-Analysis vol.149, pp.None, 2012, https://doi.org/10.1016/j.wneu.2021.01.027
  9. Anterior Cervical Corpectomy with Fusion versus Anterior Hybrid Fusion Surgery for Patients with Severe Ossification of the Posterior Longitudinal Ligament Involving Three or More Levels: A Retrospect vol.10, pp.22, 2012, https://doi.org/10.3390/jcm10225315