Rotational vertebral artery syndrome treated via an anterior approach and selective decompression only

We present the case of a 38-year-old male who complained of repeated dizziness and syncope. Rotational vertebral artery syndrome (RVAS) was diagnosed via videonystagmoraphy (VNG), computed tomography angiography (CTA) and three-position digital subtraction angiography (DSA). In the neutral position, CTA and DSA revealed left vertebral artery (VA) stenosis at the C2 transverse foramen and right VA hypoplasia. When the head was turned to the right, the blood flow stopped at the C2 level. The bony structure around the VA at the C2 transverse foramen was decompressed via an anterior surgical approach, and the symptoms resolved. This case present the precise stenotic point evaluation by three-position DSA is crucial for the planning of surgical treatment.

Comparative analysis of two hybrid technique in treating multilevel cervical spondylotic myelopathy via anterior approach / 中国骨伤

OBJECTIVE@#To compare the clinical effects and complications of two hybrid decompression techniques in treating multilevel (>=3) cervical spondylotic myelopathy(MCSM).@*METHODS@#The clinical data of 124 patients with multilevel (>=3) cervical spondylotic myelopathy treated by surgery and follow-up from January 2008 to December 2016 were retrospectively analyzed. According to the different operative methods, the patients were divided into group A and group B. Anterior cervical discectomy and fusion (ACDF) combined with anterior cervical corpectomy and fusion with preserved posterior vertebral wall (PWCF) were performed in group A; ACDF combined with anterior cervical corpectomy and fusion(ACCF) were performed in group B. There were 44 males and 16 females in group A with an average age of (60.43±7.52) years old, 46 males and 18 females in group B with an average age of (61.61±6.39) years old. No significant differences were found in gender, age between two groups. The operative time, intraoperative blood loss, hospital stay, rate of complications, postoperative Japanese Orthopaedic Association (JOA) score and improvement of cervical curvature were compared between two groups.@*RESULTS@#All the operations were successful. The follow-up time was 13 to 28(23.0±12.1) months in group A and 12 to 30(24.0±11.5) months in group B. The operative time, intraoperative blood loss, hospital stay in group B were higher than those in group A(0.05). The physiological curvature of cervical vertebra was improved significantly after operation, and there was no significant difference between two groups(>0.05).@*CONCLUSIONS@#Both surgical methods can obtain satisfactory clinical efficacy for multilevel(>=3) cervical spondylotic myelopathy, but compare with group B (ACDF combined with ACCF), group A (ACDF combined with PWCF) has shorter operation time, less trauma, less bleeding, and lower incidence of complications. ACDF combined with PWCF can be preferentially selected for the patients who corresponding to the indications.

Comparison of anterior and posterior decompression in the treatment of spinal cord injury without fracture and dislocation / 中国综合临床

Objective To investigate the clinical effect of anterior and posterior decompression internal fixation in the treatment of spinal cord injury without fracture and dislocation(CSCIWFD).Methods The clinical data of sixty-five patients with CSCIWFD in Worker's Hospital and Handan Central Hospital from December 2013 to May 2015 was analyzed.According to the surgical methods,the patients were divided into two groups,31 cases in the anterior group,accepted the anterior cervical decompression and internal fixation,34 cases in the posterior group,treated with posterior cervical open-door laminoplasty fixation.The operation time, intraoperative blood loss,neurological function recovery and complications of each group were recorded.Results The operative time in the anterior group was(63.2 ± 15.1)min and in the posterior group was(113.8 ±21.5)min,there was significant difference between the two groups(P<0.05).The intraoperative blood loss in the anterior group was lower than that in the posterior group((116.3 ± 18.9)ml vs.(236.3 ± 41.0)ml,t=55.837,P<0.05).In the anterior group,the JOA score was(6.9±1.6)points before operation,(9.6±1.9) points at 2 weeks after operation,(11.7±2.6)points at 3 months after operation and(13.5±3.1)points at the last follow-up,there were significant differences between the preoperative level and postoperative level(F between groups=33.759,P<0.05;F grouP=5.213,P<0.05;F interaction=6.769,P<0.05).In the posterior group,the JOA score was(6.7 ± 1.5)points before operation,(8.7 ± 1.8)points at 2 weeks after operation, (10.9±2.5)points at 3 months after operation and(13.1±3.4)points at the last follow-up,the differences were all statistically significant(P<0.05).Based on the JOA scores,there was significant difference between the two groups at 2 weeks after operation(P<0.05).The anterior group had 1 case of recurrent laryngeal nerve injury and 1 case of cerebrospinal fluid leakage,while the posterior group had 1 case of wound infection,1 case of liquefaction necrosis and 1 case of epidural hematoma.There was no significant difference in the complication rate between the two groups(X2= 0.000,P= 1.000).Conclusion The anterior decompression has the advantages of less operative trauma,shorter operation time,less intraoperative blood loss and quick recovery of nerve function.The selection of surgical method should be based on the compression section of the spinal cord.

Functional and Radiological Outcomes of Anterior Decompression and Posterior Stabilization via Posterior Transpedicular Approach in Thoracic and Thoracolumbar Pott's Disease: A Retrospective Study

STUDY DESIGN: This is a retrospective study. PURPOSE: To determine the efficacy and safety of a posterior transpedicular approach with regard to functional and radiological outcomes in people with thoracic and thoracolumbar spinal tuberculosis. OVERVIEW OF LITERATURE: Spinal tuberculosis can cause serious morbidity, including permanent neurological deficits and severe deformities. Medical treatment or a combination of medical and surgical strategies can control the disease in most patients, thereby decreasing morbidity incidence. A debate always existed regarding whether to achieve both decompression and stabilization via a combined anterior and posterior approach or a single posterior approach exists. METHODS: The study was conducted at the Indian Spinal injuries Centre and included all patients with thoracic and thoracolumbar Pott's disease who were operated via a Posterior transpedicular approach. Data regarding 60 patients were analyzed with respect to the average operation time, preoperative and postoperative, 6 months and final follow-up American Spinal Injury Association (ASIA) grading, bony fusion, implant loosening, implant failure, preoperative, postoperative, 6 months and final follow-up kyphotic angles, a loss of kyphotic correction, Oswestry disability index (ODI) score, and visual analog scale (VAS) score. Data were analyzed using either a paired t -test or a Wilcoxon Signed Rank test. RESULTS: The mean operation time was 260±30 minutes. Fifty-five patients presented with evidence of successful bony fusion within a mean period of 6±1.5 months. Preoperative dorsal and lumbar angles were significantly larger than postoperative angles, which were smaller than final follow-up angles. The mean kyphotic correction achieved was 12.11±14.8, with a mean decrease of 5.97 and 19.1 in VAS and ODI scores, respectively. CONCLUSIONS: Anterior decompression and posterior stabilization via a posterior transpedicular approach are safe and effective procedures, with less intraoperative surgical duration and significant improvements in clinical and functional status.

Minimally Invasive Anterior Decompression Technique without Instrumented Fusion for Huge Ossification of the Posterior Longitudinal Ligament in the Thoracic Spine: Technical Note And Literature Review

OBJECTIVE: Several surgical methods have been reported for treatment of ossification of the posterior longitudinal ligament (OPLL) in the thoracic spine. Despite rapid innovation of instruments and techniques for spinal surgery, the postoperative outcomes are not always favorable. This article reports a minimally invasive anterior decompression technique without instrumented fusion, which was modified from the conventional procedure. The authors present 2 cases of huge beak-type OPLL. Patients underwent minimally invasive anterior decompression without fusion. This method created a space on the ventral side of the OPLL without violating global thoracic spinal stability. Via this space, the OPLL and anterior lateral side of the dural sac can be seen and manipulated directly. Then, total removal of the OPLL was accomplished. No orthosis was needed. In this article, we share our key technique and concepts for treatment of huge thoracic OPLL. METHODS: Case 1. 51-year-old female was referred to our hospital with right lower limb radiating pain and paresis. Thoracic OPLL at T6–7 had been identified at our hospital, and conservative treatment had been tried without success. Case 2. This 54-year-old female with a 6-month history of progressive gait disturbance and bilateral lower extremity radiating pain (right>left) was admitted to our institute. She also had hypoesthesia in both lower legs. Her symptoms had been gradually progressing. Computed tomography scans showed massive OPLL at the T9–10 level. Magnetic resonance imaging of the thoracolumbar spine demonstrated ventral bony masses with severe anterior compression of the spinal cord at the same level. RESULTS: We used this surgical method in 2 patients with a huge beaked-type OPLL in the thoracic level. Complete removal of the OPLL via anterior decompression without instrumented fusion was accomplished. The 1st case had no intraoperative or postoperative complications, and the 2nd case had 1 intraoperative complication (dural tear) and no postoperative complications. There were no residual symptoms of the lower extremities. CONCLUSION: This surgical technique allows the surgeon to safely and effectively perform minimally invasive anterior decompression without instrumented fusion via a transthoracic approach for thoracic OPLL. It can be applied at the mid and lower level of the thoracic spine and could become a standard procedure for treatment of huge beak-type thoracic OPLL.

Anterior slip phenomenon of the vertebrae after corpectomy surgery and its clinical significance / 中国骨伤

<p><b>OBJECTIVE</b>To investigate the anterior slip phenomenon of the vertebrae after corpectomy surgery and its clinical significance.</p><p><b>METHODS</b>The clinical data of 164 patients with cervical spondylotic myelopathy treated from January 2010 to April 2013 were retrospectively analyzed. There were 88 males and 76 females, aged from 38 to 74 years old with the mean of 56.2 years. Among them, 31 cases for C₄ corpectomy, 87 cases for C₅ corpectomy, 46 cases for C₆ corpectomy. Preoperative and postoperative distance of posterior wall of vertebral canal to the line of adjacent upper vertebral bodies anterosuperior border and lower vertebral bodies anteroinferior border was measured by CT in cervical sagittal middle layer scanning as the center, anterior slip degree of the vertebrae after operation was evaluated. The fast clustering method was used, the vertebral shift distance as variable, according to the size of the forward distance, 90 cases classified as group 1(forward greatly group), and the 74 cases classified as group 2(forwad short group). The relationships on the anterior slip of the vertebrae and cervical curvature, surgical segment were analyzed. Japanese Orthopaedic Association (JOA) scores and its improvement rate were observed before and after operation, and the relationships on the anterior slip of the vertebrae and sagittal plane diagonal diameter of spinal canal, clinical effect were analyzed.</p><p><b>RESULTS</b>All the patients were followed up from 12 to 48 months with an average of 29.5 months. All operative vertebrae occurred anterior slip with different degree after corpectomy surgery, the maximum was 3.52 mm and minimum was 1.12 mm, with an average of (2.14±1.02) mm. According to the clustering method, the anterior slip distance with (3.07±0.21) mm classified as forward greatly group(90 cases, 54.9%) and the anterior slip distance with (1.55±0.32) mm classified as forwad short group(74 cases, 45.1%). There was no significant difference between anterior slip distance and operation segments(=0.01,=0.996). Cervical curvature index and anterior slip distance of operated vertebra had a positive correlation (=0.724). The incidence of reduction of the diagonal diameter of cervical spinal canal in forward greatly group was higher than that of forwad short group(=4.45,=0.035). The patients with unsatisfactory efficacy appeared obvious anterior slip of the vertebrae after corpectomy than the patients with satisfactory efficacy(<0.05).</p><p><b>CONCLUSIONS</b>Corpectomy of the cervical spine can result in vertebral forward displacement trend, and obvious displacement may cause the secondary compression of the spinal cord.</p>

Indirect Repair with Surgicel® and Fibrin Glue for Postoperative Cerebrospinal Fluid Leakage after Cervical Anterior Foraminotomy: A Case Report

STUDY DESIGN: A case report. OBJECTIVES: To report a case of indirect repair of cerebrospinal fluid (CSF) leakage after cervical anterior foraminotomy using Surgicel® and fibrin glue. SUMMARY OF LITERATURE REVIEW: There is no single modality that is best practice for this type of case because it is difficult to apply primary repair for a case of CSF leakage after cervical anterior decompression. MATERIALS AND METHODS: A 49-year-old female patient was diagnosed with CSF leakage on the second day after cervical anterior foraminotomy. We performed coverage with Surgicel® and fibrin glue at the CSF leak site. RESULTS: The patient was treated with indirect repair of CSF leakage without any complications. The clinical and radiological outcomes were excellent upon follow-up 1 year postoperatively. CONCLUSIONS: Indirect repair using Surgicel® and fibrin glue is an effective treatment for postoperative CSF leakage after cervical anterior foraminotomy.

Therapeutic effect of methylprednisolone combined with anterior decompression and internal fixation in treating cervical spine hyperextension injury / 中国生化药物杂志

Objective To analyse the therapeutic effect of methylprednisolone combined with anterior decompression and internal fixation in the treatment of cervical spine hyperextension injury. Methods 42 patients who were diagnosed with cervical hyperextension injury in orthopaedics department of the First Hospital of Jiaxing were collected.All patients were randomly divided into experimental group and control group, 21 cases in each group.Patients in control group received anterior cervical decompression and internal fixation only , patients in experimental group received methylprednisolone combined with anterior decompression and internal fixation, after treatment, the serum levels of TNF-α, SOD and American Spinal Injury Association (ASIA) score were detected in all patients.Results After treatment, compared with control group, the serum levels of TNF-αwas lower, SOD was higher and ASIA score was higher in experimental group, and the differences were statistically significant (P<0.05).Conclusion The methylprednisolone combined with anterior decompression and internal fixation could significantly reduce the serum level of TNF-α, and increase the serum level of SOD and ASIA score in patients with cervical spine hyperextension injury, could reduce the inflammatory damage, improve the antioxidant capacity, which has a good clinical effect.

Curative effect analysis of two kinds of anterior decompression and fusion methods for double cervical spondy-lotic myelopathy / 局解手术学杂志

Objective To investigate the effect of anterior cervical discectomy and interbody fusion ( ACDF) combined with titanium plate fixation technique and subtotal vertebrectomy and fusion and titanium plate internal fixation operation ( ACCF) on adjacent segmental cervical spondylotic myelopathy. Methods 76 patients with double segment spondylotic cervical myelopathy were randomly divided into AC-CF group and ACDF group,the relevant indicators of operation period,spinal cord function,anteroposterior and lateral of cervical spine and flexion-extension dynamic radiographs were observed,the Cobb’ s angle and fusion segmental height and bone fusion were recorded. Results The operation related index results showed that the operation time,bleeding volume and hospitalization time of patients in ACDF were less than those in ACCF group (P 0. 05). The postoperative Cobb’s angle degree of ACDF group is better than that of AC-CF group (P<0. 05). Conclusion The effect of ACCF and ACCF on the treatment of two-level CSM were satisfactory,of which ACDF has the advantages of short operation time,less bleeding,fusion segments of Cobb’ s angle and fewer complications.

Above two-level segment interbody fusion with double-way connection intervertebral fusion device / 中国组织工程研究

10.3969/j.issn.2095-4344.2013.26.007

A Case of Surgically Treated by Transperitoneal Approach in Delayed Neurological Deficit after Sacral Fracture: A Case Report

This study reviews a case of sacral fracture with delayed onset neurological deficit that showed good results after decompressive surgery. The delayed neurological deficit appeared at 4 weeks after injury and it was treated with anterior decompression through transperitoneal approach. A 23-year-old woman was injured in a car accident and had bilateral pubic rami fractures and fractures of the sacral ala on the right side. She was treated with external fixation devices for approximately four weeks, but complained of pain and numbness. The dorsiflexion and plantalflexion of the right ankle was weakened and graded as grade 2. Preoperative pelvic and sacral radiographs, computed tomography, magnetic resonance imaging and electromyelography, and nerve conduction study were performed to identify the region of neurological deficit, and we decided to implement neurological decompression. By transperitoneal approach, we performed bone curratage and decompression around the region of sacral alar slope and S1 foramen. The pain and numbness of the right foot cleared up. Dorsiflexion and plantalflexion of the right ankle improved to grade 5. Anterior decompression by transperitoneal approach proved to bring satisfactory results in a patient, who presented delayed neurological deficit after sacral fracture.

Is It Necessary to Add Anterior Decompression after Posterior Decompression for Thoracolumbar and Lumbar Fractures with Neurologic Deficit?

STUDY DESIGN: A retrospective study. OBJECTIVES: To understand the necessity of additional anterior decompression when treating with posterior decompression for thoracolumbar and lumbar fractures, with neurologic deficit. SUMMARY OF LITERATURE REVIEW: Additional anterior decompression is still a controversy after a posterior decompression. MATERIALS AND METHODS: We evaluated 38 patients who were treated with a decompression surgery for thoracolumbar and lumbar spine fractures with neurologic deficit. In the posterior decompression group, there were 26 patients, and there were 12 patients in the posterior and anterior decompression group. According to the Frankel grade, neurologic deficit was grade A 3, B 1, C 3, D 31, respectively. Unstable burst fractures were 22, flexion-distraction injuries 12, Chance fractures 2 and translational injuries 2 by the McAfee classification. Radiographic evaluation was carried out with comparison of the spinal canal encroachment and kyphotic angle. We evaluated the improvement of neurology, and compared with that of the preoperative canal encroachment. RESULTS: During the posterior decompression, 5 neural injuries were found in the post. decompression group, and 4 in the post. and ant. decompression group. There was no significant difference of neurologic improvement between the two groups (improvement in 18(69%) and 8(67%), respectively) (p>0.05). Preoperative canal encroachment was 62% and 76%, respectively. But, preoperative canal encroachment and final neurologic improvement showed no significant correlations between the two groups (p>0.05). CONCLUSIONS: We could not find the difference of neurologic improvement between the post. decompression group and post. and ant. decompression group. We suggest that an additional ant. decompression for the thoracolumbar and lumbar spine fractures treated with post. decompression is not necessary.

Late Occurrence of Cervicothoracic Ossification of Posterior Longitudinal Ligaments in a Surgically Treated Thoracic OPLL Patient

Ossification of the posterior longitudinal ligament (OPLL) in the thoracic spine is rare, even in the Far East. A 45-year-old female presented with a 4-month history of progressive motor weakness in the lower extremities, numbness below the midthoracic area, and spastic gait disturbance. Neuroradiological examinations revealed massive OPLLs at the T4-T6 levels with severe anterior compression of the spinal cord. Anterior decompressive corpectomies with bone grafts were performed from T4 to T6 using a trans-thoracic approach. After surgery, the patient made an uneventful recovery. However, eleven years after surgery, the patient developed recurrent lower extremity weakness and spastic gait disturbance. De novo OPLLs at the C6-T2 levels were responsible for the severe spinal cord compression on this occasion. After second surgery, paralysis in both legs was resolved. We present a rare case of late cervicothoracic OPLL in a patient surgically treated for thoracic OPLL.

Surgical Treatment of Thoracolumbar Spine Burst Fracture by Anterior Decompression Bone Grafting,Internal Fixation and Imabsolute Paralysis / 昆明医科大学学报

Objective To sum up the surgical characteristics,indications and curative effects of burst fracture by anterior decompression,bone grafting and internal fixation.Methods Since Sep 2004,6 cases with the average age of 32 who were with thoracolumbar spine burst fracture and spinal cord injury of 12-day mean time,were treated with anterior decompression,bone grafting and Z-plate steel plate internal fixation.Before the operation,pateients were classified according to the ASIA classification: 4 cases of grade C,2 cases of grade D;Kyphotic angle(Cobb)15~40?;and vertebral canal 50%~60%.Results The follow-up lasted from 6 to 16 months(average 11 months) and it was found that incision recovered better,no infection of thoracic,abdomen,no grafting loosing or braking occurred.According to the ASIA classification,the functional recovery of spinal cord was 1~2 grade.The Denis assessment showed 5 cases was light back pain,1 case needed medication from time to time but didn't affect the life and work and spine was in order.Conclusion Surgical treatment of thoracolumbar fracture by anterior decompression,bone grafting,internal fixation can provide sufficient decompression,high rate of fusion of the implanted bone,stability in the spine and vertebral body,better recovery of neurological function and satisfied curative effects.It is the best choice for thoracolumbar burst facture and spinal cord injury.

Anterior approach for treatment of thoracolumbar burst fractures by decompression and bone graft / 中国矫形外科杂志

[Objective]To discuss the clinical effect of the anterior approach for the treatment of thoracolumbar burst fractures by decompression and bone graft.[Method]A total of 34 patients underwent anterior approach for the treatment of thoracolumbar burst fractures were retrospectively analyzed from September 2003 to September 2005.According to the Denis classification system,there were 6 type A,16 type B,6 type C,4 type D,and 2 type E.Preoperative and postoperative neurologic changes,spinal canal decompression,segmental angulation,and arthrodesis rate were evaluated.[Result]The average preoperative canal compressopm decreased from 66.5% to 2.0%.Mean preoperative segmental kyphosis improved from 22.10? to 2.30?.There was neurologic deterioration.Twenty-six(86.7%) of 30 patients with neurologic deficits had an improvement by at least one modified Frankel grade.All patients went on to apparently stable arthrodesis.[Conclusion]Types of anterior spinal instrumentation and reconstruction techniques allow direct anterior decompression of neural elements,improvement in segmental angulation,and acceptable rates of arthrodesis without the need for supplemental posterior instrumentation.

Diagnosis and treatments for anterior spinal artery syndrome induced by cervical disc herniation / 中国矫形外科杂志

[Objective]To discuss the diagnosis,treatments and the outcome of anterior spinal artery syndrome induced by cervical disc herniation.[Methods]Eighteen patients(male 13,female 5,average age 35.6 years old) were diagnozed to experience cervical disc herniation by MRI scans.All the patients presented with severe motor paralysis with loss of sensation to pain and temperature but sparing of proprioceptive sensation,which was just like the clinical features of anterior spinal artery syndrome.The average preoperative JOA score was 7.6 points,ranged from 4 to 10.Anterior cervical decompression with fusion was performed on 17 patients within 15 days.Spinal canal occupation was found in 1 case.Posterior approach treatment was not effective and anterior approach decompression was performed 1 year later.[Results]All these patients were followed up for an average of 15 months(12 to 24 months).Seventeen patients had a good outcome.The postoperative JOA score ranged from 7 to 15 points(13.4 in average) and the mean JOA recovery ratio was 61.7%.All the patients recovered with no complication.[Conclusion]A herniated cervical disc can compress the spinal anterior artery and involve with anterior spinal artery syndrome.It can be final diagnozed with clinical features and MRI scans.The outcome is satisfactory when an early and complete anterior decompression with fusion is performed.

A prospective study of interbody fusion with cage versus corpectomy and fusion with plate in treating adjacent two-level cervical spondylosis / 中国矫形外科杂志

[Objective] To compare the efficacy of interbody fusion with cage versus corpectomy and fusion with plate in treating adjacent two-level cervical spondylosis.[Method] Sixty patients were included in this study.All patients were randomly assigned to anterior interbody fusion with cage (AIFC) group or anterior corpectomy and fusion with plate (ACFP) group. The average follow-up period was 28 months for AIFC group,and 25 months for ACFP group. [Result] The average loss of lordosis angle, the lost correction of segmental height and the scores on the criteria of 40-score method were not statistically significant between these 2 groups. The lordosis correction, operative estimated blood loss, and operative time were statistically better in the AIFC group significantly . [Conclusion] The short-term results of AIFC and ACFP in treating adjacent two-level cervical spondylosis were satisfactory. The advantages of AIFC are the elimination of donor site complications, increasing more segmental lordosis, and reducing blood loss and operative time.

Factors affecting prognosis of patients who underwent anterior decompression for cervical ossification of posterior longitudinal ligament:a multiple logistic regression analysis / 中国矫形外科杂志

[Objective] To discuss the prognostic factors for cervical OPLL treated by anterior decompression.[Method]A total of 48 patients with cervical OPLL,who underwent anterior decompression,were followed up for 1～4 years,with an average of 2.1 years.The patients were classified into a good-prognosis group and a poor-prognosis group according to the JOA neruologic scoring system.Age,sex,JOA score,duration of symptoms,diabetes mellitus,Pavolv ratio,occupying rate,type of ossification,CT double-layer sign,hyperintense areas,level of segments,and treatment of ossification were testified using multiple logistic regression analysis.[Result]Treatment of ossification was the only statistically significant factor predicting clinical results in this study.[Conclusion]It is the most important to resect the ossification and decompress the spinal cord thoroughly in the process of antarior decompression for cervical OPLL.

Primary clinical application of new pterygo-shape titanium mesh cage in surgical procedure of cervical spondylosis / 中国矫形外科杂志

[Objective]To apply interal fixation with new pterygo-shape titanium mesh cage in the treatment of degenarative cervical spondylosis.[Method]Twenty-seven patients of degenarative cervical spondylosis were reconstructed after vertecotomy with the cage including 19 cases of CDH,8 cases of OPLL,18 cases in male and 9 cases in female;single segment degenaration were 21 cases,double segment degenaration were 6 cases.All cases were excluded fracture,dislocate by X-ray and MRI preoperatly.[Result]All 27 patients were followed up for an average time of 10 months(from 6 to 14 months).The anverage time of bone graft fusion was 10 weeks.[Conclusion]The pterygo_shape titanium mesh cage can provide immediate biomechanical stability and prevent the mesh cage displace,subsidence,exodus after operation.The surgical procedure is simple,safety and without illic-bone graft,meanwhile can greatly relieve patients' economy burden.Then the internal fixation is elastic fixation,the bone fusion shows a satisfactory result.

Anterior microsurgical decompression and fusion via cervical disc space / 中国矫形外科杂志

[Objective]To oberserve the method and efficacy of anterior microsurgical decompression and fusion via cervical disc space in the treatment of cervical spondylotic myelopathy.[Method]Forty-three patients were treated with microsurgical decompression via cervical disc space and fusion with PEEK(Polyetheretherketone)cages.Preoperative,immediate postoperative and follow-up X-ray films were utilized to oberserve the fusion rate of the segments,and to evaluate the restoration of lordosis(Cobb's angle)and intervertebral height.[Result]All patients were followed up with an average of 15.4 months.The fusion rate was 100% and the satisfactory rate was 88.4% according to the 40 score method.Immediate postoperative X-ray films showed 6.0?improvement in lordosis(P