对单节段切除进行了五年的随访

Castro Frank Phillip
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引用次数: 0

摘要

单节段颈椎前路减压融合(ACDF)最初采用髂嵴骨移植(ICBG)进行[1]。几十年后,随着手术技术的改变,加入前钢板固定术,融合率提高了[2,3]。机械同种异体移植和钢板固定技术的单节段ACDFs最终成为行业标准,因为它显示出与ICBG的单节段ACDFs相同的融合率和更少的并发症。该手术技术被扩展用于连续椎间盘突出患者。采用机械同种异体移植物或椎间间隔器和两节段钢板进行多节段ACDFs,可缩短手术时间,减少出血量,更好地恢复前凸,减少即时疼痛[4]。成功的多级ACDFs受植骨来源[5]、吸烟成瘾[6]和构建体稳定性[7]的强烈影响。在中央椎体放置两枚额外的固定螺钉是手术技术的另一项改进,与仅在末端椎体放置螺钉相比,增加了构建体的强度[8]。使用同种异体移植物治疗多节段ACDFs是一个设备缺点,因为它们通常导致高不愈合率[9,10]。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Five-year follow up on the single level corpectomy
Single-level Anterior Cervical Decompression and Fusion (ACDF) was initially performed using Iliac Crest Bone Graft (ICBG) [1]. Fusion rates improved when a surgical technique change, the addition of anterior plate ixation, was incorporated decades later [2,3]. Single level ACDFs with a machined allograft and plate ixation technique eventually became the industry standard as it demonstrated equivalent fusion rates with fewer complications than single level ACDFs with ICBG. This surgical technique was extended for use in patients with contiguous disk herniations. Multilevel ACDFs performed with machined allografts or interbody spacers and a two-level plate offered shorter operative times, less blood loss, better restoration of lordosis, and less immediate pain [4]. Successful multi-level ACDFs were strongly in luenced by the bone graft source [5], the smoking addiction [6], and the construct stability [7]. Placement of two additional ixation screws in the central vertebral body, another improvement in the surgical technique, increased the construct strength compared to constructs with screws only placed into the end vertebral bodies [8]. Using allografts for multilevel ACDFs was a device disadvantage as they often resulted in high nonunion rates [9,10].
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