Bone grafting related complications in 92 patients undergoing different kinds of anterior cervical surgeries: Entire autogenous bone versus Pyramesh bone graft / 中国组织工程研究

ABSTRACT

BACKGROUND:Anterior cervical plate can maximize the intervertebral space height,expand intervertebral foramen,restore cervical physiological antecurvature,prevent instability due to implant micromovement,and increase graft fusion.However,the selection of entire autologous bone or Ti-mesh bone graft remains uncertain in application of anterior cervical plate.OBJECTIVE:To compare the complications of three different intervertebral fusion methods in anterior cervical decompression surgery.METHODS:A total of 92 cases of cervical spondylotic myelopathy were treated by anterior cervical decompression and three different intervertebral fusion methods.They were followed up for at least 3 months.Of them,6 underwent bone grafting alone,21 underwent autogenous bone graft with cervical plate-screw fixation,and 65 underwent pyramesh with anterior cervical plate-screw fixation.Complications were observed in all cases.RESULTS AND CONCLUSLONA total of 2 of 6 autogenous bone grafting cases suffered from graft bone dislocation,1 suffered from pseudoarthrosis formation,and 1 suffered from donated ilium.Six of 21 autogenous bone graft with cervical plate-screw fixation suffered from loss of intervertebral height,and 3 suffered from pain of donated ilium.Eleven of 65 pyramesh with anterior cervical plate-screw fixation suffered from titanium mesh subsidence,1 case suffered from breakage of fixation screw.Simple autogenous bone grafting surgery was rarely used due to long duration of external fixation and too much complications.Autogenous bone grafting with anterior cervical plate-screw fixation surgery has shortage of grafted bone absorption and pain of donated ilium.Pyramesh with anterior cervical plate-screw fixation surgery overcomes the shortage of donated iliac pain,but remains the shortage of titanium mesh subsidence and lose of intervertebral height.