engleski

Less invasive surgical approach to multilevel cervical spondylosis

Background: Harvesting iliac crest bone for cervical fusion has been associated with significant morbidity. To avoid it, various synthetic materials have been developed. Aim of this study was to evaluate efficacy of hydroxyapatite ( HA) in multilevel cervical interbody fusion at one year follow-up. Methods: Eighty-six patients with degenerative cervical disc disease underwent 215 cervical interbody fusion procedures in which either Smith-Robinson or Cloward type HA grafts were used. Indications for surgery included radiculopathy in 38 cases, myelopathy in 20 cases and their combination in 28 patients. Plating systems were not used in 11 patients but various sorts of anterior plating systems were used in the remainder. Postoperatively patients were followed for a mean of 12.64 months. All patients underwent radiography to evaluate the fusion, degree of the lordosis and the intervertebral disc height. Results: Excellent clinical results (86%) were obtained in patients with radiculopathy. There were 5 grafts mobilization and one graft fracture. Two grafts extruded in non-instrumented patients and required repeat surgery. There were another three reoperations due to the hardware problem and consequently pseudoarthrosis. One year fusion rate was obtained at 86.9 % for two level surgery, 80.1 % for three level surgery and 74 % for four level surgery. Mean hospital stay was 3.8 days. Conclusion: An HA graft can be very effective synthetic material even for three and four level cervical interbody fusion. It is characterized by a high fusion rate and a small percentage of graft-related complications especially if fusion procedure is followed by plating

cervical spondylosis; hydroxiapatite; multilevel cervical interbody fusion

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