Multilevel anterior cervical interbody fusion with hydroxiapatite grafts (CROSBI ID 502107)
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Podaci o odgovornosti
Vukić, Miroslav ; Walters, C. Beverly ; Jednačak, Hrvoje ; Saftić, Robert ; Paladino, Josip
engleski
Multilevel anterior cervical interbody fusion with hydroxiapatite grafts
Objective: To avoid morbidity of harvesting iliac crest bone for cervical fusion, numerous materials such as allografts, have been developed. However, the medical literature suggests that allografts are associated with a lower fusion rate. Hydroxyapatite grafts (HA) have numerous advantages, including their standard shapes, simplicity of use, load resistance and porosity. The aim of this study was to evaluate efficacy of HA in multilevel cervical interbody fusion at one year follow-up. Methods: Sixty-four patients with degenerative cervical disc disease underwent 159 cervical interbody fusion procedures in which either Smith-Robinson or Cloward type HA grafts were used. Indications for surgery included radiculopathy in 34 cases, myelopathy in 16 cases and a combination in14 patients. Plating systems were not used in 10 patients and various sorts of anterior plating systems were used in the remainder. Postoperatively patients were followed for a mean of 13.2 months. All the patients underwent radiography to evaluate fusion, degree of lordosis and the intervertebral disc height. Clinical results were interpreted on the base of Odom's classification. Results: Excellent clinical results (89%) were obtained in patients with radiculopathy. Three grafts deteriorated and one graft fractured. Two grafts extruded in non-indtrumented patients and required repeat surgery. There were three reoperations due to hardware problems once the fusion had occurred. In all but one case postoperative radiographic lordosis and disc height were maintained. Fusion rate was 63 % at six months follow-up increasing to 94.4% at one year follow-up. Mean hospital stay was 4.3 days. Conclusions: An HA graft can be very effective synthetic material even for multilevel cervical interbody fusion. It is characterized by a high fusion rate and a small percentage of graft-related complications, especially when arthrodesis is achieved with plating.
anterior cervical interbody fusion; hydroxiapatite grafts; cervical spondylosis; cervical disc
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Podaci o prilogu
2004.
objavljeno
Podaci o matičnoj publikaciji
Podaci o skupu
Spine i S.E. today- first spine oriented regional meeting
predavanje
01.01.2004-01.01.2004
Mokrice, Slovenija