Usefulness of Anterior Cervical Interbody Fusion Using Locally Harvested Bone: Locally Harvested Bone Versus Autogenous Iliac Bone / 대한정형외과학회잡지

PURPOSE: The purpose of this study is to evaluate the usefulness of locally harvested bone in anterior cervical interbody fusion. MATERIALS AND METHODS: A retrospective review was conducted, including 31 patients who underwent anterior cervical interbody fusion using a polyetheretherketone (PEEK) cage and anterior plate fixation. We randomly divided the patients into two groups, local bone group and iliac bone group. In 15 patients of the local bone group, the cage was filled with locally harvested bone, and in another 16 patients of the iliac bone group, the cage was filled with autogenous iliac bone. RESULTS: Improvements in mean visual analogue scale (VAS) scores, from 5.8 and 7.7 to 1.6 and 2.3 for neck pain and arm pain, respectively, were observed in cases using locally harvested bone, while the improvements were from 5.7 and 7.2 to 1.4 and 2.2, respectively, in those using autogenous iliac bone grafts. However, no significant differences in mean VAS and neck disability index were observed between the two groups at the last follow up (p>0.05). Radiologic union was achieved at 14.0+/-2.50 weeks in the local bone group, and at 12.62+/-1.58 weeks in the iliac bone group. However, no significant difference was observed between the two groups (p=0.076). CONCLUSION: Utilization of locally harvested bone for packing in a PEEK cage for anterior cervical interbody fusion is considered a useful method because it gives satisfactory clinical results for retention of bone union and lordosis angles.

Congenital Hypoplasia of the Posterior Arch of the Atlas Associated with a Fracture of the Odontoid Process: A Case Report

STUDY DESIGN: Case report. OBJECTIVES: To report a rare posterior arch hypoplasia of the atlas and review the clinical significance. SUMMARY OF LITERATURE REVIEW: Congenital hypoplasia of posterior arch of the atlas is uncommon. In particular, the combined fracture of the odontoid process has not been reported. MATERIALS AND METHODS: A 56-year-old man developed severe neck pain after a traffic accident. Cervical CT scan revealed a fracture of the odontoid process and hypoplasia of posterior arch of the atlas. RESULTS: Bony union was achieved after halo vest immobilization for three months. CONCLUSIONS: Hypoplasia of posterior arch of the atlas is determined incidentally in asymptomatic patients. However, the patients should be evaluated in detail with a 3D CT and MRI to avoid a misinterpretation as fracture, instability or misdiagnosis.